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Purpose: To identify the change in clinical and microbiological profiles of pediatric microbial keratitis in Taiwan between 1998-2002 and 2008-2012., Design: Retrospective, observational study., Method: setting: Chang Gung Memorial Hospital, a referral center in Taiwan. patient population: We retrospectively reviewed the medical records of 68 eyes of 67 children aged 16 years or younger who were diagnosed with microbial keratitis and treated at our hospital between July 2008 and December 2012. main outcomes and measures: Predisposing factors, isolated organisms, antibiotic susceptibility, and clinical outcomes. The findings were compared with the results of our previous study conducted between July 1998 and December 2002., Results: As in 1998-2002, the leading risk factor for microbial keratitis during 2008-2012 was contact lens use, and the infection rate significantly increased from 40.7% to 52.9% (P = .024), which was mainly attributable to the recent increase in the rate of orthokeratology-related keratitis from 9.9% to 19.1% (P = .011). Pseudomonas aeruginosa remained the most commonly isolated organism (30.6%), but the number of isolated coagulase-negative Staphylococcus cases increased significantly in the 2008-2012 cases (P = .04). Antibiotic susceptibility of organisms did not change significantly between the 2 study periods. By using multiple linear stepwise regression analysis, we found that gram-negative bacterial infection played a crucial role in poor visual outcome., Conclusions: Contact lens-related microbial keratitis increased in Taiwanese children over time, especially because of the use of overnight orthokeratology. Clinicians must understand the infection background and pay further attention to contact lens use in pediatric patients., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: To investigate the clinical settings, treatment given, and visual outcomes for eyes with Pseudomonas aeruginosa endophthalmitis in Taiwan., Methods: This is a retrospective, noncomparative, consecutive case series. Medical records were reviewed in 72 eyes of 71 patients with culture-proven P. aeruginosa endophthalmitis between January 1997 and December 2007., Results: The clinical settings included keratitis/scleritis (44.4%), cataract surgery (15.3%), penetrating keratoplasty (13.9%), endogenous source (12.5%), trauma (6.9%), penetrating keratoplasty with cataract surgery (2.8%), trabeculectomy with cataract surgery (1.4%), trabeculectomy (1.4%), and secondary implant (1.4%). Initial visual acuity ranged from counting fingers to no light perception. Final visual acuity was better than 5/200 in 6 of 72 eyes (8.3%), 4/200 to hand motions in 4 eyes (5.6%), and light perception to no light perception in 62 eyes (86.1%). In vitro testing, the susceptibility patterns of organisms isolated were as follows: ceftazidime (100%), cefepime (100%), aztreonam (100%), imipenem (99%), amikacin (94%), and gentamicin (86%). Five of 16 eyes (31.3%) that underwent primary or secondary pars plana vitrectomy with intravitreal antibiotics achieved a final visual acuity of 5/200 or better compared with 1 of 45 eyes (2.2%) treated with 1 or multiple vitreous tap(s) and intravitreal antibiotics (Fisher's exact test, P = 0.004)., Conclusion: Despite early diagnosis and treatment with intravitreal antibiotics, visual acuity outcomes were generally poor.

Objectives: To assess the antibiotic susceptibility of bacteria isolated from corneal ulcers in cats., Methods: A total of 92 cats with infected corneal ulcers were swabbed for bacterial culture and the antibiotic sensitivity of the isolates analysed., Results: Bacteria were isolated from 54 of 92 infected eyes with corneal ulcers and purulent discharge. A total of 59 bacterial isolates were obtained from the 54 ulcers. The ratio of Gram-positive to Gram-negative isolates was approximately 3:1. The most commonly isolated Gram-positive bacteria were Staphylococcus species (51 per cent of all isolates), while Pseudomonas aeruginosa (13.5 per cent of all isolates) was the most common Gram-negative bacteria isolated. The Gram-negative isolates demonstrated a greater incidence of antibiotic resistance than the Gram-positive ones. The most effective antibiotics against the isolates were ciprofloxacin, tobramycin and gentamicin, with erythromycin and lincomycin showing the greatest number of resistant isolates., Clinical Significance: Staphylococcus and Pseudomonas species were the most common Gram-positive and Gram-negative bacteria, respectively, isolated from feline eyes with ulcerative keratitis. The second-generation fluoroquinolone, ciprofloxacin and the aminoglycoside gentamicin were found to be highly effective against the majority of isolates.

Objectives: To analyse antibiotic susceptibility of bacteria associated with ulcerative keratitis in dogs., Methods: Bacteria isolated from 190 eyes with ulcerative keratitis were identified, and the antibiotic susceptibility of isolates was studied., Results: In total, 258 species of bacteria were isolated from the 190 eyes. Of the isolates, 78 per cent were Gram-positive and 28 per cent were Gram-negative bacteria. The most commonly isolated Gram-positive bacteria in dogs were Staphylococcus spp (49 per cent), Streptococcus spp (7 per cent) and Corynebacterium spp (7 per cent); while Pseudomonas aeruginosa (7.6 per cent) and Escherichia coli (5.8 per cent) were the commonest Gram-negative pathogens. Resistance to commonly used ophthalmic antibiotics was seen in Staphylococcus, Streptococcus, Corynebacterium, Pseudomonas and Escherichia species isolates., Clinical Significance: Isolates from dogs with corneal ulcers in Taiwan may be resistant to several commonly used ophthalmic preparations. Ciprofloxacin showed good action against most isolates, with the notable exception of Streptococcus species. Chloramphenicol or cephalothin had the best in vitro action against the Streptococcus species isolates.