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Epidemiological characteristics of microbiological results on patients with infectious corneal ulcers: a 13-year survey in Paraguay

  • Clinical Investigation
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Abstract

Background

This is a retrospective, chart-reviewed study of patients diagnosed with infectious corneal ulcers at the Ophthalmology Department of the National University of Asunción in Paraguay. The microbiological culture results are described, as well risk factors for the development of fungal keratitis.

Methods

After obtaining approval from the Institutional Review Board, an analysis of medical charts from 1988 to 2001 was conducted and 660 patients were identified to have been diagnosed with infectious corneal ulcers due to bacteria or fungi. Demographic data were recorded, including age, gender, occupation and geographic location of their home and work (city or rural). Other information collected included the history of the presenting illness, past and current use of ocular medications and whether or not they had a history of trauma or contact lens use. Each patient had an eye examination performed by an ophthalmologist and corneal scrapings were obtained for cultures in all cases. Microbiologic culture results were analyzed.

Results

Twenty-one percent (136/660) of the specimens collected from the patients’ conjunctiva and cornea were sterile in all culture media. Of the 524 (79%) positive cultures, 267 were due to bacteria (51%), 136 to fungi (26%), and 121 (23%) cultures yielded both fungi and bacteria. Of the 430 isolated bacteria approximately 25% (103) were coagulase negative Staphylococcus, followed by 23% (94) Staphylococcus aureus, 14% (60) Pseudomonas aeruginosa and 13% (56) Streptococcus pneumoniae. Acremonium species accounted for 40% (79) of all fungi identified, followed by Fusarium species (15%) (41). Approximately two-thirds of the patients were male (n = 435). For those patients for whom a history was available, approximately half had a history of trauma. Of these, half of these again involved foreign bodies. Over-the-counter medications were used commonly, and most of those patients had a delay in diagnosis of over 1 week. Risk factors for fungal keratitis as opposed to bacterial keratitis were male gender, agricultural occupation, age between 30 and 59, history of trauma and self-medication.

Conclusions

The results of this study provide demographic data on patients with infectious corneal ulcers in Paraguay. Common causes of such ulcers are both bacteria and fungi. Most patients had self-medicated, and most had delayed seeking professional medical care.

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Acknowledgements

The authors thank the Georg-and-Hannelore Zimmermann Foundation and the Department of Ophthalmology at the Ludwig-Maximilian University, Munich, Germany, for their financial and technical support of this study.

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Authors and Affiliations

  1. Research Institute of Health-Science (IICS), National University of Asunción, Asunción, Paraguay

    Florentina Laspina, Margarita Samudio, Norma Fariña & Ramona Sanabria

  2. Department of Ophthalmology, National University Hospital, Asunción, Paraguay

    Diógenes Cibils

  3. Department of Ophthalmology, School of Medicine, Stanford University, 300 Pasteur Drive, Room A-157, Stanford, California, 94305-5308, USA

    Christopher N. Ta & Herminia Miño de Kaspar

  4. Department of Ophthalmology, Ludwig-Maximilian University, Munich, Germany

    Volker Klauß & Herminia Miño de Kaspar

Authors
  1. Florentina Laspina
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  2. Margarita Samudio
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  3. Diógenes Cibils
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  4. Christopher N. Ta
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  5. Norma Fariña
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  6. Ramona Sanabria
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  7. Volker Klauß
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  8. Herminia Miño de Kaspar
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Corresponding author

Correspondence to Herminia Miño de Kaspar.

Additional information

This article was presented in part at the Paraguayan Congress of Infectology, Asunción, Paraguay, in 0ctober 2001.

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Laspina, F., Samudio, M., Cibils, D. et al. Epidemiological characteristics of microbiological results on patients with infectious corneal ulcers: a 13-year survey in Paraguay. Graefe's Arch Clin Exp Ophthalmol 242, 204–209 (2004). https://doi.org/10.1007/s00417-003-0808-4

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  • DOI: https://doi.org/10.1007/s00417-003-0808-4

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