Ãlcera corneana em serviÃo oftalmolÃgico de referÃncia

AUTOR(ES)

Rosangela Rosendo da Silva

DATA DE PUBLICAÇÃO

2007

RESUMO

Corneal ulceration is an important cause of ocular morbidity and preventable blindness. Several studies have reported the incidence of bacterial and fungal pathogens isolated from ulcerated corneas. The purpose of this study was to analyze the microbiology of corneal ulcers and the factors associated in patients cared for at Altino Ventura Foundation Emergency Service, Recife â PE, from November 2005 to November 2006. Forty patients were identified to have been diagnosed with corneal ulcers. Sociodemographic data and information pertaining to the risk factors were recorded, all patients were examined and corneal cultures was performed. Twenty patients (62.5%) were males and 15 (37.5%) females. The age ranged from 10 to 79 years (mean age 45.0 Â 16.7). The most common occupations were agricultural workers, 11 (27.5%) and domestic work, 9 (22.5%). Cultures were positive in 28 (70.0%) of all cases. Of these, 18 (64.3%) had only bacterial growth, 4 (14.3%) had only fungal growth and 6 (21.4%) had both bacterial and fungal growth. Nineteen isolates were Gram-positive bacteria and 5 (20.8%) Gram-negative bacteria. Coagulase negative Staphylococcus was the most common organism, composing 33.5% of all isolates, folowed by Staphylococcus aureus (12.5%) and Bacilus sp. (12.5%). Pseudomonas sp. was the most common Gram- negative organisms isolated (8.3%). Fungi were isolated in 10 cases (35.7%). Aspergillus sp. was the most prevalent fungal pathogens reported (30.0%). Regarding bacterial susceptibility to antibiotics we found 50% of strains resistant to oxacilina, 33.3% to cefalotina, and 33.3% to tobramicina. The principal predisposing factors identified in this study were trauma (25.6%), severe systemic disease (14.0%), ocular disease (11.6%) and previous ocular surgery in the same eye (11.6%). Bacterial ulcers are more common than fungal ulcers. Coagulase negative Staphylococcus accounting for the majority of bacterial ulcers and Aspergillus sp. responsible for most of the fungal infections. These UregionalU findings have important implications for the treatment and prevention of corneal ulceration

ASSUNTO(S)

medicina fatores predisponentes Ãlcera de cÃrnea ceratite/etiologia keratitis/etiology microbiologia corneal ulcer microbiology predisposing factors

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