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Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management

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Abstract

Purpose

To study predisposing factors, clinical presentation and management strategies for Klebsiella keratitis.

Methods

A retrospective case review was performed on clinical records of culture-proven Klebsiella keratitis cases in a tertiary referral center over an 8-year period (from 2012 to 2020).

Results

Thirty eight episodes of culture-proven Klebsiella keratitis were identified in 37 patients. The mean age of the patients was 62.9 years (range, 24–101). Multiple predisposing factors were identified in 33 eyes including history of previous keratoplasty (n = 11) history of ocular trauma (n = 7), preexisting ocular surface disease (n = 7) and diabetes (n = 6). Corrected distance visual acuity (CDVA) at presentation was light perception (LP) in 16 patients, hand motion (HM) in 12, counting fingers (CF) at 50 cm in 5, CF at 1 m in 1, CF at 2 m in 2. One patient had a CDVA of 3/10. On initial examination Hypopyon was detected in 21 eyes. Descemet's membrane folds were present in 1 eye. Corneal thinning was identified in 20 eyes and perforation occurred in 4 patients. Corneal ulcer progressed to endophthalmitis in one patient. Microbiologic sensitivity testing showed that 89.5% isolates were sensitive to amikacin (34/38),88.9%sensitive to ceftazidime (32/36),94.4% were sensitive to gentamicin (34/36),97.2% sensitive to ciprofloxacin (35/36), and 100% to levofloxacin (26/26).Ultimately, one or more surgical procedures was needed in 21 patients.

Conclusion

Previous keratoplasty, history of ocular trauma, ocular surface disease and systemic disease such as diabetes are major risk factors for Klebsiella keratitis. In most of the patients, surgical and tectonic procedures were necessary to control the infection.

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Funding

No funding was received for conducting this study. The authors have no financial and non-financial interests to disclose.

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Authors and Affiliations

  1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, 1336616351, Tehran, Iran

    Ahmad Masoumi, Haniyeh Zeidabadinejad, Behzad Jafari, Amirreza Esfandiari & Mohammad Soleimani

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  1. Ahmad Masoumi
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  2. Haniyeh Zeidabadinejad
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  3. Behzad Jafari
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  4. Amirreza Esfandiari
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  5. Mohammad Soleimani
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Contributions

AM and MS designed the study. BJ and AE gathered the data related to this study. AM analyzed the data. HZM and AM wrote the main manuscript text. All authors reviewed the manuscript.

Corresponding author

Correspondence to Mohammad Soleimani.

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Masoumi, A., Zeidabadinejad, H., Jafari, B. et al. Infectious keratitis caused by Klebsiella spp.: predisposing factors, presentation, and management. Int Ophthalmol 43, 1169–1173 (2023). https://doi.org/10.1007/s10792-022-02515-y

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  • DOI: https://doi.org/10.1007/s10792-022-02515-y

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