Polymicrobial Keratitis: Risk Factors, Clinical Characteristics, Bacterial Profile, and Antimicrobial Resistance

Laura A González-Dibildox, José A Oyervidez-Alvarad, Kristian A Vazquez-Romo, Nallely Ramos-Betancourt, Everardo Hernandez-Quintela, Francisco Beltra, Manuel Garza-Leon

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


OBJECTIVE: To describe clinical characteristics, complications, and the most prevalent microorganisms causing polymicrobial keratitis and their antibiotic sensitivities.

METHODS: A cross-sectional study including a consecutive analysis of patient's records with a diagnosis of bacterial keratitis with a positive culture and antibiogram report were included. Patients were grouped into those having monomicrobial and polymicrobial infection. Features studied included demographic and clinical characteristics, risk factors, Gram stain, cultures, and antibiotic sensitivity.

RESULTS: We included 656 patients; in 31.5% more than one microorganism was found. Seven hundred and twenty-three gram-positive bacteria were isolated, and 336 (46.5%) had polymicrobial keratitis. One hundred sixty-one gram-negative bacteria were isolated, and 99 (61.5%) from polymicrobial keratitis. Fourteen (0.60%) patients presented ring infiltrate, and 10 (71.42%) of those patients had polymicrobial keratitis (X2 10.654, P=0.001). Multivariate analysis showed that patients with history of contact lens use (odds ratio [OR] of 1.78, P=0.042), coexistent autoimmune disease (OR 4.64, P=0.03), irregular edges of the infiltrate (OR 2.06, P=0.005), and ring infiltrate (OR 6.034, P=0.005) have a higher risk for developing polymicrobial infection. In the polymicrobial group, gram-positive and gram-negative organisms showed a high sensitivity to Netilmicin.

CONCLUSIONS: We found a high incidence of polymicrobial keratitis. Our results suggest that it should be suspected in patients with a history of contact lens use, coexistent autoimmune disease, infiltrates with indistinct edges, and ring infiltrates. Sensitivities to moxifloxacin are lower than those reported in previous studies, but sensitivity to Netilmicin is higher.

Original languageEnglish
Pages (from-to)465-470
Number of pages6
JournalEye & contact lens
Issue number8
Early online date18 Feb 2021
Publication statusPublished - 1 Aug 2021

Bibliographical note

Publisher Copyright:
© 2020 Contact Lens Association of Ophthalmologists, Inc.

All Science Journal Classification (ASJC) codes

  • Ophthalmology


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