{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:09:20Z","timestamp":1774339760011,"version":"3.50.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Objectives:<\/jats:title><jats:p>To study the microbial profile, antibiotic susceptibility pattern, risk factors, therapeutic trends, and clinical outcomes for microbial keratitis (MK) in a tertiary health care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>All cases with suspected bacterial keratitis that were followed at consultation from September 2007 to August 2015 were included. Microbial cultures were obtained and patients were managed following an internal protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Two hundred thirty-five patients were included, with a mean age of 50.01\u00b120.73 years. We obtained a 38.4% culture-positive rate, with higher proportion of gram-positives (70.8%). The commonest agents were<jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>(23.1%),<jats:italic toggle=\"yes\">Corynebacterium macginleyi<\/jats:italic>(20.0%), and<jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>(13.8%). Fluoroquinolone susceptibility was 97%, with no trend toward its decrease. A total of 95.7% had local risk factors, being trauma and contact lens wear the most common (28.9% each), with different age and pathogens distributions (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001). Topical fluoroquinolones were first-line treatment in 99%, in association with aminoglycosides in 81.6%. Good initial response was registered in 95.9%, but 4.1% needed to step up treatment to fortified antibiotics, mainly if<jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>(<jats:italic toggle=\"yes\">P<\/jats:italic>=0.021). Good outcome was achieved in 81.8%, negatively affected by exposure and herpetic keratitis (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001), central location (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.01), presence of Tyndall (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001), corneal edema (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001), and worse initial best-corrected visual acuity (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001), but not<jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>isolate (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.724).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Gram-positives are the most frequent pathogens and shifting trends in the isolate distribution or emergence of resistant strains were not demonstrated. The susceptibility to first-line antibiotic agents remained high. We suggest a more aggressive approach to<jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>cases or MK presenting with poor outcome variables.<\/jats:p><\/jats:sec>","DOI":"10.1097\/icl.0000000000000298","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T15:13:56Z","timestamp":1468509236000},"page":"15-20","source":"Crossref","is-referenced-by-count":38,"title":["Clinical and Microbiological Profile of Bacterial Microbial Keratitis in a Portuguese Tertiary Referral Center\u2014Where Are We in 2015?"],"prefix":"10.1097","volume":"44","author":[{"given":"Carla Sofia","family":"Ferreira","sequence":"first","affiliation":[]},{"given":"Luis","family":"Figueira","sequence":"additional","affiliation":[]},{"given":"Nuno","family":"Moreira-Gon\u00e7alves","sequence":"additional","affiliation":[]},{"given":"Ra\u00fal","family":"Moreira","sequence":"additional","affiliation":[]},{"given":"Luis","family":"Torr\u00e3o","sequence":"additional","affiliation":[]},{"given":"Fernando","family":"Falc\u00e3o-Reis","sequence":"additional","affiliation":[]}],"member":"276","reference":[{"key":"R1-20230912","first-page":"1027","article-title":"Estimated burden of keratitis\u2013United States, 2010","volume":"63","author":"Collier","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R2-20230912","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1016\/j.ophtha.2012.03.031","article-title":"Shifting trends in bacterial keratitis in Toronto: an 11-year review","volume":"119","author":"Lichtinger","year":"2012","journal-title":"Ophthalmology"},{"key":"R3-20230912","doi-asserted-by":"crossref","first-page":"769436","DOI":"10.1155\/2015\/769436","article-title":"Predisposing factors, microbial characteristics, and clinical outcome of microbial keratitis in a tertiary centre in Hong Kong: a 10-year experience","volume":"2015","author":"Ng","year":"2015","journal-title":"J Ophthalmol"},{"key":"R4-20230912","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ophtha.2005.08.013","article-title":"Microbial keratitis predisposing factors and morbidity","volume":"113","author":"Keay","year":"2006","journal-title":"Ophthalmology"},{"key":"R5-20230912","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1038\/sj.eye.6700151","article-title":"Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America","volume":"16","author":"Lam","year":"2002","journal-title":"Eye (Lond)"},{"key":"R6-20230912","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0039-6257(79)90127-9","article-title":"Initial therapy of suspected microbial corneal ulcers. 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