{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:06:38Z","timestamp":1783929998456,"version":"3.55.0"},"reference-count":39,"publisher":"Knowledge E DMCC","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["JOVR"],"abstract":"<jats:p>Purpose: This study aimed to document the spectrum of isolated microorganisms and investigate the risk factors associated with infectious keratitis over a 12-year period at a tertiary referral center. Methods: A retrospective analysis was conducted on the medical records of 867 patients diagnosed with infectious keratitis between 2009 and 2021. Corneal scraping was performed for 414 patients, and all individuals received fortified empiric antibiotic eye drops. Surgical intervention was conducted for 376 patients during their hospital stay. Results: Trauma emerged as the most prevalent risk factor (21.9%). The main causative microorganism for corneal ulcers was found to be Pseudomonas aeruginosa. Staphylococcus aureus was the primary microorganism isolated in patients below 50 years old, whereas P. aeruginosa was more commonly identified in patients aged 50 and above. Tarsorrhaphy was performed on 23.6% of the patients. Additionally, other surgical procedures were undertaken in 44.6% of the cases, with tectonic graft and corneal patch graft emerging as the most frequent surgical interventions. Conclusion: This study underscores the importance of trauma as the leading predisposing factor and P. aeruginosa as the predominant microorganism isolated in cases of adult microbial corneal ulcers in Iran<\/jats:p>","DOI":"10.18502\/jovr.v21.18405","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:03:20Z","timestamp":1783926200000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors and Common Organisms in Bacterial Keratitis in a Tertiary Center in Iran"],"prefix":"10.18502","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-2950","authenticated-orcid":false,"given":"Yasaman","family":"Hadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Gholamalizadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Ghiasian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negar","family":"Dadpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5641-4390","authenticated-orcid":false,"given":"Navid","family":"Elmi Sadr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3048-0258","authenticated-orcid":false,"given":"Marjan","family":"Mazouchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7770","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"337495","doi-asserted-by":"crossref","unstructured":"1. Rahimi F, Hashemian MN, Khosravi A, Moradi G, Bamdad S. Bacterial keratitis in a tertiary eye centre in Iran: A retrospective study. Middle East Afr J Ophthalmol 2015;22:238-244.","DOI":"10.4103\/0974-9233.151870"},{"key":"337496","doi-asserted-by":"crossref","unstructured":"2. Khoo P, Cabrera-Aguas MP, Nguyen V, Lahra MM, Watson SL. Microbial keratitis in Sydney, Australia: Risk factors, patient outcomes, and seasonal variation. Graefes Arch Clin Exp Ophthalmol 2020;258:1745-1755.","DOI":"10.1007\/s00417-020-04681-0"},{"key":"337497","doi-asserted-by":"crossref","unstructured":"3. Austin A, Lietman T, Rose-Nussbaumer J. Update on the management of infectious keratitis. Ophthalmology 2017;124:1678-1689.","DOI":"10.1016\/j.ophtha.2017.05.012"},{"key":"337498","doi-asserted-by":"crossref","unstructured":"4. Chang HY, Chodosh J. Diagnostic and therapeutic considerations in fungal keratitis. Int Ophthalmol Clin 2011;51:33-42.","DOI":"10.1097\/IIO.0b013e31822d64dc"},{"key":"337499","doi-asserted-by":"crossref","unstructured":"5. Jeng BH, Gritz DC, Kumar AB, Holsclaw DS, Porco TC, Smith SD, et al. Epidemiology of ulcerative keratitis in Northern California. Arch Ophthalmol 2010;128:1022-1028.","DOI":"10.1001\/archophthalmol.2010.144"},{"key":"337500","doi-asserted-by":"crossref","unstructured":"6. Upadhyay MP, Karmacharya PC, Koirala S, Shah DN, Shakya S, Shrestha JK, et al. The Bhaktapur eye study: Ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal. Br J Ophthalmol 2001;85:388-392.","DOI":"10.1136\/bjo.85.4.388"},{"key":"337501","doi-asserted-by":"crossref","unstructured":"7. Soleimani M, Tabatabaei SA, Masoumi A, Mirshahi R, Ghahvechian H, Tayebi F, et al. Infectious keratitis: Trends in microbiological and antibiotic sensitivity patterns. Eye (Lond) 2021;35:3110-3115.","DOI":"10.1038\/s41433-020-01378-w"},{"key":"337502","unstructured":"8. O\u2019Brien KS, Lietman TM, Keenan JD, Whitcher JP. Microbial keratitis: A community eye health approach. Community Eye Health 2015;28:1-2."},{"key":"337503","doi-asserted-by":"crossref","unstructured":"9. Stapleton F. The epidemiology of infectious keratitis. Ocul Surf 2023;28:351-363.","DOI":"10.1016\/j.jtos.2021.08.007"},{"key":"337504","doi-asserted-by":"crossref","unstructured":"10. Jin H, Parker WT, Law NW, Clarke CL, Gisseman JD, Pflugfelder SC, et al. Evolving risk factors and antibiotic sensitivity patterns for microbial keratitis at a large county hospital. Br J Ophthalmol 2017;101:1483-1487.","DOI":"10.1136\/bjophthalmol-2016-310026"},{"key":"337505","unstructured":"11. Ravinder K, Madhav MV, Archana J, Pandurang J. Clinical evaluation of corneal ulcer among patients attending teaching hospital. Diabetes 2016;6:7-5."},{"key":"337506","doi-asserted-by":"crossref","unstructured":"12. Ibrahim YW, Boase DL, Cree IA. Epidemiological characteristics, predisposing factors and microbiological profiles of infectious corneal ulcers: The Portsmouth corneal ulcer study. Br J Ophthalmol 2009;93:1319-1324.","DOI":"10.1136\/bjo.2008.151167"},{"key":"337507","doi-asserted-by":"crossref","unstructured":"13. Mah-Sadorra JH, Yavuz SG, Najjar DM, Laibson PR, Rapuano CJ, Cohen EJ. Trends in contact lens-related corneal ulcers. Cornea 2005;24:51-58.","DOI":"10.1097\/01.ico.0000138839.29823.57"},{"key":"337508","unstructured":"14. Cruciani F, Cuozzo G, Di Pillo S, Cavallaro M. Predisposing factors, clinical and microbiological aspects of bacterial keratitis: A clinical study. Clin Ter 2009;160:207-210."},{"key":"337509","unstructured":"15. Keshav BR, Zacheria G, Ideculla T, Bhat V, Joseph M, Keshav BR, et al. Epidemiological characteristics of corneal ulcers in South sharqiya region. Oman Med J 2008;23:34-39."},{"key":"337510","doi-asserted-by":"crossref","unstructured":"16. Titiyal JS, Negi S, Anand A, Tandon R, Sharma N, Vajpayee RB; PMCID. Risk factors for perforation in microbial corneal ulcers in north India. Br J Ophthalmol 2006;90:686-689.","DOI":"10.1136\/bjo.2005.079533"},{"key":"337511","doi-asserted-by":"crossref","unstructured":"17. Al-Yousuf N. Microbial keratitis in kingdom of bahrain: Clinical and microbiology study. Middle East Afr J Ophthalmol 2009;16:3-7.","DOI":"10.4103\/0974-9233.48855"},{"key":"337512","unstructured":"18. Suen CT, Ean TC, Din NM. A 5-year retrospective review of corneal ulcers in Northern Malaysia. Age (Melbourne, Vic) 2021;21:6."},{"key":"337513","doi-asserted-by":"crossref","unstructured":"19. Hsiao CH, Sun CC, Yeh LK, Ma DH, Chen PY, Lin HC, et al. Shifting trends in bacterial keratitis in Taiwan: A 10-year review in a tertiary-care hospital. Cornea 2016;35:313-317.","DOI":"10.1097\/ICO.0000000000000734"},{"key":"337514","doi-asserted-by":"crossref","unstructured":"20. Liu HY, Chu HS, Wang IJ, Chen WL, Hu FR. Microbial keratitis in Taiwan: A 20-year update. Am J Ophthalmol 2019;205:74-81.","DOI":"10.1016\/j.ajo.2019.03.023"},{"key":"337515","doi-asserted-by":"crossref","unstructured":"21. Khor WB, Prajna VN, Garg P, Mehta JS, Xie L, Liu Z, et al.; ACSIKS Group. The Asia Cornea Society Infectious Keratitis Study: A prospective multicenter study of infectious keratitis in Asia. Am J Ophthalmol 2018;195:161-170.","DOI":"10.1016\/j.ajo.2018.07.040"},{"key":"337516","doi-asserted-by":"crossref","unstructured":"22. Tavassoli S, Nayar G, Darcy K, Grzeda M, Luck J, Williams OM, et al. An 11-year analysis of microbial keratitis in the South West of England using brain-heart infusion broth. Eye (Lond) 2019;33:1619-1625.","DOI":"10.1038\/s41433-019-0463-6"},{"key":"337517","doi-asserted-by":"crossref","unstructured":"23. Schaefer F, Bruttin O, Zografos L, Guex-Crosier Y. Bacterial keratitis: A prospective clinical and microbiological study. Br J Ophthalmol 2001;85:842-847.","DOI":"10.1136\/bjo.85.7.842"},{"key":"337518","doi-asserted-by":"crossref","unstructured":"24. Bourcier T, Thomas F, Borderie V, Chaumeil C, Laroche L. Bacterial keratitis: Predisposing factors, clinical and microbiological review of 300 cases. Br J Ophthalmol 2003;87:834-838.","DOI":"10.1136\/bjo.87.7.834"},{"key":"337519","doi-asserted-by":"crossref","unstructured":"25. Ruiz Caro JM, Cabrejas L, de Hoz MR, Mingo D, Duran SP. Clinical features and microbiological in bacterial keratitis in a tertiary referral hospital. Arch Soc Esp Oftalmol 2017;92:419-425.","DOI":"10.1016\/j.oftale.2017.03.013"},{"key":"337520","doi-asserted-by":"crossref","unstructured":"26. Tena D, Rodr\u00edguez N, Toribio L, Gonz\u00e1lez-Praetorius A. Infectious keratitis: Microbiological review of 297 cases. Jpn J Infect Dis 2019;72:121-123.","DOI":"10.7883\/yoken.JJID.2018.269"},{"key":"337521","doi-asserted-by":"crossref","unstructured":"27. Kim MR, Lee SB. Clinical and microbiological analysis of gram-positive bacterial keratitis, a 15-year review. J Korean Ophthalmol Soc 2014;55:1432-1444.","DOI":"10.3341\/jkos.2014.55.10.1432"},{"key":"337522","doi-asserted-by":"crossref","unstructured":"28. Passos RM, Cariello AJ, Yu MC, H\u00f6fling-Lima AL. Microbial keratitis in the elderly: A 32-year review. Arq Bras Oftalmol 2010;73:315-319.","DOI":"10.1590\/S0004-27492010000400002"},{"key":"337523","doi-asserted-by":"crossref","unstructured":"29. Ahmed NH, Mishra D, Rathod P, Satpathy G, Titiyal JS, Tandon R, et al. Spectrum of bacterial keratitis in North India: A retrospective analysis of six years at a tertiary care eye center. Indian J Ophthalmol 2022;70:1982-1989.","DOI":"10.4103\/ijo.IJO_2915_21"},{"key":"337524","doi-asserted-by":"crossref","unstructured":"30. Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Shivkumar C, Palaniappan R. Epidemiology of bacterial keratitis in a referral centre in south India. Indian J Med Microbiol 2003;21:239-245.","DOI":"10.1016\/S0255-0857(21)03006-1"},{"key":"337525","doi-asserted-by":"crossref","unstructured":"31. Galletti JG, de Paiva CS. The ocular surface immune system through the eyes of aging. Ocul Surf 2021;20:139-162.","DOI":"10.1016\/j.jtos.2021.02.007"},{"key":"337526","doi-asserted-by":"crossref","unstructured":"32. Fleiszig SM, Evans DJ. The pathogenesis of bacterial keratitis: Studies with Pseudomonas aeruginosa. Clin Exp Optom 2002;85:271-278.","DOI":"10.1111\/j.1444-0938.2002.tb03082.x"},{"key":"337527","doi-asserted-by":"crossref","unstructured":"33. Evans DJ, Fleiszig SM. Why does the healthy cornea resist Pseudomonas aeruginosa infection? Am J Ophthalmol 2013;155:961-970.e2.","DOI":"10.1016\/j.ajo.2013.03.001"},{"key":"337528","doi-asserted-by":"crossref","unstructured":"34. Vazirani J, Wurity S, Ali MH. Multidrug-resistant Pseudomonas aeruginosa keratitis: Risk factors, clinical characteristics, and outcomes. Ophthalmology 2015;122:2110-2114.","DOI":"10.1016\/j.ophtha.2015.06.007"},{"key":"337529","doi-asserted-by":"crossref","unstructured":"35. Orlans HO, Hornby SJ, Bowler IC. In vitro antibiotic susceptibility patterns of bacterial keratitis isolates in Oxford, UK: A 10-year review. Eye (Lond) 2011;25:489-493.36. Durrani AF, Atta S, Bhat AK, Mammen A, Dhaliwal D, Kowalski RP, et al. Methicillin-resistant Staphylococcus aureus keratitis: Initial treatment, risk factors, clinical features, and treatment outcomes. Am J Ophthalmol 2020;214:119-126.","DOI":"10.1016\/j.ajo.2020.03.017"},{"key":"337530","doi-asserted-by":"crossref","unstructured":"37. Bhuiya M, Sarkar MK, Sohag MH, Ali H, Roy CK, Akther L, et al. Enumerating antibiotic susceptibility patterns of Pseudomonas aeruginosa isolated from different sources in Dhaka City. Open Microbiol J 2018;12:172-180.","DOI":"10.2174\/1874285801812010172"},{"key":"337531","doi-asserted-by":"crossref","unstructured":"38. Gain P, Jullienne R, He Z, Aldossary M, Acquart S, Cognasse F, et al. Global survey of corneal transplantation and eye banking. JAMA Ophthalmol 2016;134:167-173.","DOI":"10.1001\/jamaophthalmol.2015.4776"},{"key":"337532","doi-asserted-by":"crossref","unstructured":"39. Tuli S, Gray M. Surgical management of corneal infections. Curr Opin Ophthalmol 2016;27:340-347.","DOI":"10.1097\/ICU.0000000000000274"},{"key":"337533","doi-asserted-by":"crossref","unstructured":"40. Sharma N, Jain M, Sehra SV, Maharana P, Agarwal T, Satpathy G, et al. Outcomes of therapeutic penetrating keratoplasty from a tertiary eye care centre in northern India. Cornea 2014;33:114-118.","DOI":"10.1097\/ICO.0000000000000025"}],"container-title":["Journal of Ophthalmic and Vision Research"],"original-title":[],"link":[{"URL":"https:\/\/knepublishing.com\/index.php\/JOVR\/article\/download\/18405\/32075","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/knepublishing.com\/index.php\/JOVR\/article\/download\/18405\/32076","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/knepublishing.com\/index.php\/JOVR\/article\/download\/18405\/32075","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:16:12Z","timestamp":1783926972000},"score":1,"resource":{"primary":{"URL":"https:\/\/knepublishing.com\/index.php\/JOVR\/article\/view\/18405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":39,"URL":"https:\/\/doi.org\/10.18502\/jovr.v21.18405","relation":{},"ISSN":["2008-322X","2008-2010"],"issn-type":[{"value":"2008-322X","type":"electronic"},{"value":"2008-2010","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}