{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:28:33Z","timestamp":1792718913496,"version":"4.5.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coinfection keratitis, involving concurrent infections by bacteria and fungi, poses diagnostic and therapeutic challenges. This study aimed to describe the microbiological and clinical characteristics of keratitis co-infections, including prevalence, predisposing factors, treatment and antimicrobial susceptibility profiles, in patients from a tertiary ophthalmology referral center in Mexico City.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective and descriptive study analyzed data collected over an 8-year period (2012\u20132020) following STROBE guidelines. Corneal samples from patients diagnosed with infectious keratitis were cultured. Only cases with confirmed coinfections-defined as the isolation of more than one microorganism-were included. Microbiological identification and antimicrobial susceptibility were analyzed. Clinical data included demographics, risk factors, visual acuity, corneal reepithelialization, and surgical interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 306 microorganisms were isolated from 140 patients. Among them, 109 cases (78%) involved bacterial-bacterial coinfections, and 31 cases (22%) were bacterial-fungal coinfections.\n                      <jats:italic>Staphylococcus epidermidis<\/jats:italic>\n                      was the most frequently isolated bacterial species (28%), and\n                      <jats:italic>Fusarium<\/jats:italic>\n                      was the predominant fungal isolate (52%). Resistance to erythromycin (52%), clindamycin (46%), and fluoroquinolones (35%) were observed, particularly among\n                      <jats:italic>S. epidermidis<\/jats:italic>\n                      isolates. Previous ocular surgery (34%) and diabetes mellitus (20%) were the most common risk factors. Similar dominant species were observed among institutional monomicrobial isolates analyzed for contextual reference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This retrospective and descriptive study characterizes microbial coinfections in infectious keratitis and provides contextual data from microbial cases from the same institution. Coinfection often involves multidrug-resistant organisms and occurs in patients with risk factors such as prior ocular surgery, contact lens use, or diabetes. Early identification and targeted therapy remain essential to improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2025.1648962","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:31:33Z","timestamp":1764225093000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Microbial coinfection keratitis: clinical spectrum, pathogen distribution, and antimicrobial susceptibility in an 8-year retrospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Mar\u00eda F.","family":"Acosta-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Antonio","family":"Bautista-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana Gabriela","family":"Ponce-Angulo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Anaya-Barrag\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Manuel","family":"Bautista-de Lucio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1097\/ICO.0b013e3181f23704","article-title":"Clinical aspects and prognosis of mixed microbial (bacterial and fungal) keratitis","volume":"30","author":"Ahn","year":"2011","journal-title":"Cornea"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1007\/s12281-013-0150-1","article-title":"Current thoughts in fungal keratitis: diagnosis and treatment","volume":"7","author":"Ansari","year":"2013","journal-title":"Curr. 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