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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Topical steroids potentiate Pseudomonas keratitis in the absence of concomitant antibiotic therapy. The effects of other anti-inflammatory agents on microbial keratitis are unknown, but if these agents do not intensify the infection, they may be useful in the initial management of microbial keratitis by limiting ulceration and thus the size of the resultant corneal scar. In rabbit models of untreated Pseudomonas keratitis and pneumococcal keratitis, topical 1% prednisolone phosphate, 0.03% flurbiprofen sodium, and vehicle were applied hourly. In cases of Pseudomonas keratitis, prednisolone worsened the clinical disease, and flurbiprofen further worsened the disease. When combined with effective antibiotic therapy, neither anti-inflammatory agent worsened the disease. In pneumococcal keratitis, neither anti-inflammatory agent worsened the disease. Topical anti-inflammatory agents should be used with caution in cases of microbial keratitis at least until effective antibiotic therapy has been instituted.
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PMID:Topical anti-inflammatory agents in an animal model of microbial keratitis. 236 36

Ten isolates of Pseudomonas aeruginosa obtained from the corneas of patients with Pseudomonas keratitis adhered to soft contact lenses in significantly greater numbers than did six isolates from other body sites (P less than .05). However, there was no predominant serotype among the 10 corneal isolates tested. Isolates grown statically in broth at 37 degrees C formed a pellicle and adhered two times as much to contact lenses as did isolates grown in broth while shaking which did not form a pellicle (P less than .01). The more adherent isolates (grown at 37 degrees C) were shown to be more hydrophobic than the less adherent bacteria (grown at 26 degrees C) by their propensity to accumulate at the interface between hexadecane and saline and their movement into polyethylene glycol from dextran. These corneal isolates agglutinated erythrocytes, a process that was inhibited by dilute solutions (as low as 0.01%) of three commonly used surfactants. These same surfactants inhibited the adherence of Pseudomonas aeruginosa to soft contact lens surfaces by as much as 52%. It is concluded that hydrophobic interactions may significantly contribute to the ability of Pseudomonas aeruginosa to adhere to contact lenses.
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PMID:The contribution of bacterial surface hydrophobicity to the process of adherence of Pseudomonas aeruginosa to hydrophilic contact lenses. 249 54

Some patients with infectious keratitis have no clinically demonstrable corneal abrasion predisposing them to infection. Subtle, undetectable corneal injuries may facilitate bacterial adherence to the cornea, eventually leading to keratitis. To study this concept, we have developed a rabbit model in which a partial-thickness corneal epithelial defect was induced by filter paper impression on the cornea that removed one to two layers of corneal epithelium. Following this injury, the corneas were incubated with Pseudomonas aeruginosa, washed, and the number of bacteria adhering to the injured corneas as well as to control corneas was quantitated. Corneas treated with filter paper, either ex vivo or in vivo, allowed 20 times more bacteria to adhere than did the untreated control corneas (P less than 0.01). This superficial epithelial defect increased Pseudomonas adherence to the cornea for up to 72 hr after injury. When corneal injury was extended to the stroma, the adherence of Pseudomonas was further augmented as compared to adherence to the superficially injured cornea. Thus, we conclude that a clinically subtle, partial-thickness corneal epithelial injury can markedly facilitate the adherence of Pseudomonas aeruginosa, which may be an important predisposing factor for infectious keratitis.
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PMID:A partial-thickness epithelial defect increases the adherence of Pseudomonas aeruginosa to the cornea. 249 55

We studied the effect of minimal antibiotic therapy on pseudomonas keratitis in rabbits. Both corneas of 12 rabbits were infected with Pseudomonas aeruginosa and treated 24 and 48 h later with two drops of tobramycin or placebo. Corneal infections in antibiotic- and placebo-treated groups were comparable in appearance 24 and 48 h after inoculation. However, bacterial recovery was significantly less in eyes treated with minimal antibiotic therapy (p = 0.009). Although negative cultures were obtained from 11 of 12 antibiotic-treated eyes, bacteria could be recovered from eight of these culture negative corneas when corneas were ground and cultured. These studies suggest that minimal antibiotic therapy may impair bacterial recovery without completely eradicating live organisms.
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PMID:Effect of minimal antibiotic treatment on bacterial keratitis. 250 Oct 67

We analyzed bacterial and fungal contamination within the contact lens care systems of ten patients who had Acanthamoeba detected within their care systems. Seven patients had Acanthamoeba keratitis, one had Pseudomonas keratitis, and the remaining two were asymptomatic. Gram-negative bacteria were found in all ten care systems, and Pseudomonas was found in six. Bacillus species, the only gram-positive bacteria isolated, were found in five systems. Fungi were isolated in six care systems. The use of homemade saline and the two-cup method of peroxide disinfection were associated with microbial contamination. Acanthamoeba organisms were found only in contact lens cases or solutions that also had bacterial and in many cases fungal contamination, suggesting that the presence of bacterial and fungal contamination within the contact lens care system may be an important element for the survival and growth of Acanthamoeba.
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PMID:Microbial analysis of contact lens care systems contaminated with Acanthamoeba. 250 18

New or used extended-wear soft contact lenses, preincubated in suspensions of Pseudomonas aeruginosa, were placed on the corneas of rabbits. The lids were then sutured shut for either 1 or 2 weeks. Bacterial keratitis occurred in 9 of 9 eyes fitted with the used contaminated lenses but in none of 12 eyes fitted with new contaminated or new noncontaminated lenses. Similar experiments were carried out with other lenses specifically designed to fit the cornea of rabbits. Some of these lenses were preworn by rabbits for 1 week (used), whereas others were new. A significantly greater incidence of bacterial keratitis was found in eyes that had undergone lid closure after the placement of used contaminated lenses (4 of 5) than in closed eyes with new contaminated lenses (1 of 8) and in open eyes with used contaminated lenses (0 of 13). These findings suggest that extended eyelid closure is a risk factor in the experimental model and may be a factor in clinical Pseudomonas keratitis associated with the wearing of extended-wear soft contact lenses.
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PMID:Effect of lid closure on contact lens-associated Pseudomonas keratitis. 251 Jul 7

Melioidosis is an infection of humans and animals caused by a gram-negative motile bacillus, Pseudomonas pseudomallei. Forty-nine patients with melioidosis complicating diabetes mellitus, collagen vascular disorders, leukemia/lymphoma, and other hematologic malignancies are described. Twenty-nine of these patients had disseminated/septicemic infection, two developed toxic shock syndrome, and one with AIDS experienced recrudescent melioidosis. Patients with disseminated melioidosis often have a variety of defects in cellular immunity both in vitro and in vivo. In humans with recrudescent melioidosis, cellular immunity can be transferred by a transfer factor and by levamisole, a cellular immunopotentiating agent. The results of the treatment of our patients with disseminated/septicemic melioidosis with antimicrobial agents in combination have been successful. In recent years, four cases of fungal arteritis due to Pythium species and one case of keratitis due to Pythium were seen. Almost all patients with fungal arteritis had thalassemia; all presented with pain in the lower extremities and gangrenous lesions of the toes. Pythium species, an aquatic Phycomycetes, was identified in these cases as a human pathogen on the basis of clinical features, pathologic findings, and--of greatest importance--the isolation of the etiologic fungi. These five cases with remarkably similar presentations exhibited certain similarities with and differences from cases of mucormycosis, entomophthoromycosis, and peniciliosis.
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PMID:Tropical disease in the immunocompromised host: melioidosis and pythiosis. 260 81

Effectiveness of treatment of 23 patients (23 eyes) with keratitis of Pseudomonas aeruginosa etiology was analysed. The complex treatment including activated carbon fiber material (AUVM "Dneper") allowed to arrest the purulent process in 91.3% of cases, increased the effectiveness of the treatment, shortened the patient's stay in the hospital by 4.2 bed-days, increased visual acuity in 78.2% of patients.
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PMID:[New developments in the treatment of keratitis of Pseudomonas aeruginosa etiology]. 263 54

Pseudomonas cepacia has recently become recognized as a virulent pathogen responsible for nosocomial infections in hosts with altered immunity. It has been implicated in endophthalmitis and conjunctivitis, and is resistant to conventional antipseudomonal therapy. No cases of P. cepacia keratitis have been reported in the literature. We report such a case in association with topical steroid and contact lens use following penetrating keratoplasty. In addition, we developed an experimental model of P. cepacia keratitis in the rabbit. P. cepacia should be considered as a cause of infectious keratitis especially in nosocomial infections in immunocompromised corneas.
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PMID:Pseudomonas cepacia keratitis. 264 11

Complete records from 175 patients with 176 episodes of culture-proven bacterial keratitis treated over a 4-year period at the Massachusetts Eye and Ear Infirmary in Boston were analyzed. Sixty-three percent of the infections involved gram-positive organisms, and 40% involved gram-negative organisms; 15% were polymicrobial. There was a high incidence of infection with Staphylococcus aureus (28%), coagulase-negative staphylococci (14%), diphtheroids (14%), Pseudomonas aeruginosa (14%), and Streptococcus pneumoniae (12%). Gram stain correlation was achieved in 55%. Potential predisposing factors, usually multiple, were identified in 97% of the patients. Fifty percent of the ulcers were associated with such iatrogenic factors as prior topical corticosteroid therapy, penetrating keratoplasty, and contact lens use. Trauma occurred in only 16%. Several statistically significant associations of epidemiologic factors and outcome variables were revealed. Ninety-five percent of the ulcers resolved with therapy, but only 44% of the patients had visual acuity better than the level at admission, and 13% developed major complications.
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PMID:Factors influencing predilection and outcome in bacterial keratitis. 271 94


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