Infectious keratitis: an update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance

Ting, Darren Shu Jeng; Ho, Charlotte Shan; Deshmukh, Rashmi; Said, Dalia G.; Dua, Harminder S.

Abstract

Corneal opacity is the 5th leading cause of blindness and visual impairment globally, affecting ~6 million of the world population. In addition, it is responsible for 1.5–2.0 million new cases of monocular blindness per year, highlighting an ongoing uncurbed burden on human health. Among all aetiologies such as infection, trauma, inflammation, degeneration and nutritional deficiency, infectious keratitis (IK) represents the leading cause of corneal blindness in both developed and developing countries, with an estimated incidence ranging from 2.5 to 799 per 100,000 population-year. IK can be caused by a wide range of microorganisms, including bacteria, fungi, virus, parasites and polymicrobial infection. Subject to the geographical and temporal variations, bacteria and fungi have been shown to be the most common causative microorganisms for corneal infection. Although viral and Acanthamoeba keratitis are less common, they represent important causes for corneal blindness in the developed countries. Contact lens wear, trauma, ocular surface diseases, lid diseases, and post-ocular surgery have been shown to be the major risk factors for IK. Broad-spectrum topical antimicrobial treatment is the current mainstay of treatment for IK, though its effectiveness is being challenged by the emergence of antimicrobial resistance, including multidrug resistance, in some parts of the world. In this review, we aim to provide an updated review on IK, encompassing the epidemiology, causative microorganisms, major risk factors and the impact of antimicrobial resistance.

Citation

Ting, D. S. J., Ho, C. S., Deshmukh, R., Said, D. G., & Dua, H. S. (2021). Infectious keratitis: an update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance. Eye, 35, 1084-1101. https://doi.org/10.1038/s41433-020-01339-3

• Journal Article Type: Article
• Acceptance Date: Nov 22, 2020
• Online Publication Date: Jan 7, 2021
• Publication Date: 2021-04
• Deposit Date: Jan 12, 2021
• Journal: Eye
• Print ISSN: 0950-222X
• Electronic ISSN: 1476-5454
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 35
• Pages: 1084-1101
• DOI: https://doi.org/10.1038/s41433-020-01339-3
• Keywords: Ophthalmology; General Arts and Humanities
• Public URL: https://nottingham-repository.worktribe.com/output/5223866
• Publisher URL: https://www.nature.com/articles/s41433-020-01339-3
• Additional Information: Received: 20 July 2020; Revised: 22 October 2020; Accepted: 24 November 2020; First Online: 7 January 2021; : ; : The authors declare that they have no conflict of interest.