{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:49:30Z","timestamp":1790948970033,"version":"4.1.0"},"reference-count":62,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013831","name":"University of Medicine and Pharmacy of Craiova","doi-asserted-by":"publisher","award":["000000"],"award-info":[{"award-number":["000000"]}],"id":[{"id":"10.13039\/501100013831","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Infectious keratitis is a significant global problem that can lead to corneal blindness and visual impairments. This study aimed to investigate the etiology of infectious bacterial and fungal keratitis, identify the causative pathogens and their antimicrobial resistance patterns, and analyze the risk factors associated with the development of infectious keratitis. The study was observational and retrospective, involving 226 eyes from 223 patients presented at the Ophthalmology Clinic of the County Clinical Emergency Hospital of Craiova, Romania. The inclusion criteria included corneal ulceration\/abscess\/infiltrate present on slit-lamp examination and positive microbiological sampling for bacteria or fungi. The study found that the most common causes of infectious keratitis were coagulase-negative staphylococci (35.40%), Staphylococcus aureus (11.06%), and Pseudomonas aeruginosa (14.16%). The Gram-positive bacteria showed high resistance rates to penicillin, moderate rates to gentamycin and clindamycin, and low resistance to chinolones. The Gram-negative bacteria were highly resistant to ampicillin and amoxicillin\u2013clavulanic acid, while third-generation cephalosporins, quinolones, and carbapenems were effective. Systemic antibiotics, such as vancomycine, piperacillin\u2013tazobactam, amikacin, and ceftazidime, show promise against keratitis with low resistance rates, whereas carbapenems and topical aminoglycosides had higher resistance, leaving moxifloxacin as a potential topical option for Gram-positive bacteria and Pseudomonas aeruginosa, albeit with resistance concerns for Klebsiella spp. Although fungal keratitis was rare, Fusarium spp. and Candida albicans were the leading fungal pathogens, with incidences of 2.65% and 2.21%, respectively. Candida albicans was broadly susceptible to most antifungals, while Fusarium solani, Curvularia lunata, and Alternaria alternata exhibited resistance to many antifungals. Amphotericin B and caspofungin can be used as systemic antifungals in fungal keratitis. The study also identified risk factors for keratitis such as ocular trauma (65.92%, OR: 2.5), contact lens wear (11.94%, OR: 1.8), and corneal scarring\/leukoma (10.17%, OR: 1.6). Keratitis was more frequent in individuals over 60 years old. The findings of this study have implications for the development of effective diagnostic, therapeutic, and preventive strategies for infectious keratitis.<\/jats:p>","DOI":"10.3390\/microorganisms12040787","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T11:09:20Z","timestamp":1712920160000},"page":"787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania"],"prefix":"10.3390","volume":"12","author":[{"given":"Andrei Theodor","family":"B\u0103l\u0103\u0219oiu","sequence":"first","affiliation":[{"name":"Ophtalmology Department, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania"},{"name":"Ophtalmology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"B\u0103l\u0103\u0219oiu","sequence":"additional","affiliation":[{"name":"Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania"},{"name":"Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-3838","authenticated-orcid":false,"given":"Ovidiu Mircea","family":"Zlatian","sequence":"additional","affiliation":[{"name":"Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania"},{"name":"Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9829-972X","authenticated-orcid":false,"given":"Alice Elena","family":"Ghenea","sequence":"additional","affiliation":[{"name":"Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania"},{"name":"Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"716572","DOI":"10.3389\/fpsyg.2021.716572","article-title":"The Welleye: A Conceptual Framework for Understanding and Promoting Wellbeing","volume":"12","author":"Dolan","year":"2021","journal-title":"Front. 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