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

Collagen shields made of porcine collagen were placed in a solution containing tobramycin sulfate (40 or 200 mg/ml) for five minutes, then applied to rabbit eyes. One, four, or eight hours after application, the corneas, aqueous humor samples, and shields were assayed for antibiotic. At all intervals, the concentration of antibiotic in the corneas and aqueous humor samples exceeded the mean inhibitory concentration for tobramycin, as determined for most strains of Pseudomonas. Shields immersed in 200 mg/ml tobramycin produced significantly higher concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .0001). Shields immersed in 40 mg/ml tobramycin produced higher, although not significantly higher, concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .318). Shields immersed in commercially available tobramycin drops or injectable tobramycin solution (40 mg/ml) caused no epithelial damage visible by slitlamp examination. Collagen shields containing antibiotics can serve as a vehicle for drug delivery and may prove superior to current methods for preoperative and postoperative antibiotic prophylaxis and the initial treatment of bacterial keratitis.
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PMID:Collagen shield drug delivery: therapeutic concentrations of tobramycin in the rabbit cornea and aqueous humor. 318 30

We assessed the comparative sensitivities of acridine orange and Gram stains in the examination of corneal scrapings using an experimental model of Pseudomonas aeruginosa keratitis. Acridine orange was more sensitive than Gram stain, requiring concentrations of about 10(4) colony-forming units/mg of corneal tissue compared to approximately 10(5) colony-forming units/mg. Our clinical experience with 21 consecutive cases of suspected microbial keratitis showed a similar diagnostic accuracy of acridine orange and Gram stain. Acridine orange accurately predicted culture results in 15 of 21 specimens (71%) compared to a diagnostic accuracy of 62% (13 of 21 specimens) for Gram stain.
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PMID:Comparison of acridine orange and Gram stains in bacterial keratitis. 319 52

In an experimental model of Pseudomonas keratitis, 50 rabbit eyes were treated with gentamicin sulfate (3 mg/mL) prophylactically on four different treatment regimens. One group (13 eyes) received one drop of gentamicin sulfate every hour to a total of four drops, the last drop 25 minutes before inoculation. A second group (13 eyes) was given one drop of gentamicin sulfate one hour before inoculation. A third group (12 eyes) received one drop of gentamicin sulfate per minute to a total of 4 drops, the last drop 25 minutes prior to inoculation. A fourth group (12 eyes) received one drop of antibiotic 25 minutes before inoculation. Twelve control eyes received saline solution. Subsequently, a superficial corneal scratch was inflicted and each eye received one drop (0.05 mL) of a solution containing Pseudomonas aeruginosa. The infection rate in all four experimental groups was low, whereas all control eyes became infected. These results demonstrate the effectiveness of prophylactic antibiotic application in the prevention of Pseudomonas keratitis prior to superficial ocular trauma.
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PMID:True prophylactic gentamicin application in experimental Pseudomonas keratitis. 320 30

A 21 year old man developed Pseudomonas aeruginosa keratitis 23 months after a reoperation for radial keratotomy. The ulcer developed in one of the inferior incision sites, presumably as a result of poor epithelial wound healing. Prompt medical therapy with fortified antibiotics led to normal visual recovery.
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PMID:Delayed microbial keratitis following radial keratotomy. 320 32

Invasive bacterial eye infections in the neonate range from perforating keratitis to panophthalmitis. These infections have gained clinical and therapeutic importance since mortality rates are high and prognosis concerning preservation of vision is poor. Effective antibiotics against the infective agents are now available. Risk factors for developing invasive bacterial eye infections are mainly prematurity and colonisation with Pseudomonas aeruginosa.
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PMID:Bacterial endophthalmitis in neonates. 330 66

Two hundred twenty-seven cases of microbial keratitis reported in nonreferral county practice were studied. The staphylococci, Pseudomonas aeruginosa and Streptococcus pneumoniae, were the major isolates. A multivariate statistical model was developed to evaluate possible predisposing and outcome determinants. Several racial and age-related relationships were shown. The interaction of numerous local ocular and systemic factors played a fundamental role in causing disease. The authors found significant association between S. pneumoniae and topical steroid use, and direct and indirect linkage of S. aureus with diabetes and trauma, respectively. S. pneumoniae and Moraxella were risk factors for major complications (24% of cases); S. pneumoniae was related to enucleation and late perforation. Corneal exposure and prior topical steroids were associated with prolonged hospital stays. Hypopyon was associated with pneumococcal infection, 60 years of age or older, and trauma. The identification of groups at high-risk for microbial keratitis and problems of preventive management are discussed.
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PMID:Epidemiology of microbial keratitis in southern California. A multivariate analysis. 331 83

In a series of 227 consecutive, non-referred patients with microbial keratitis an analysis of the accumulated hospital records showed that one-third were associated with chronic alcoholism. The diagnosis of alcoholism was usually unsuspected on admission to hospital. The microbial pathogenesis in these patients was distinctive; coagulase-negative staphylococci, alpha- and beta-streptococci, moraxellae, enteric Gram-negative bacilli, and polymicrobial infections were unusually prominent. Pseudomonas aeruginosa was uncommon. Trauma, exposure, bullous keratopathy, other external ocular diseases, and self-neglect were the major recognised predisposing causes. The nutritional, toxic and immunological sequelae of alcoholism may also have been contributory. Ophthalmologists should be alert to the diagnosis of chronic alcoholism in their patients. Chronic alcoholism may be an important and underrated risk factor for microbial keratitis.
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PMID:Chronic alcoholism and microbial keratitis. 334 17

We studied seven cases of severe gram-negative microbial keratitis associated with the use of contaminated topical ocular medications. Five cases involved Pseudomonas aeruginosa, one involved Serratia marcescens, and one involved Proteus mirabilis. In each case the same organism was cultured from corneal scrapings and from the medication. Either prednisolone acetate (one case) or timolol maleate (seven cases) was implicated in all instances.
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PMID:Microbial keratitis associated with contaminated ocular medications. 335 28

Enoxacin is a broad-spectrum quinolone-derivative antibiotic. In a rabbit model of keratitis caused by a Pseudomonas species, enoxacin (3 mg/mL) was as effective as gentamicin sulfate (3 mg/mL) and enoxacin (10 mg/mL) in reducing viable bacterial counts in corneas after 24 hours of hourly therapy with eye drops. Bacterial counts were reduced by about 5000-fold by enoxacin treatment when compared with placebo-treated controls. Penetration studies of topical enoxacin (3 mg/mL) showed that concentrations in cornea and aqueous humor reached levels above reported minimal inhibitory concentrations when an epithelial defect was present. Further investigation of enoxacin for treatment of ocular disease is warranted.
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PMID:Treatment of experimental Pseudomonas corneal ulcers with enoxacin, a quinolone antibiotic. 346 52

Rabbits vaccinated with lipopolysaccharide endotoxins or with purified protease preparations from Pseudomonas aeruginosa and Serratia marcescens before corneal challenge with the viable bacteria exhibited significantly less corneal damage than rabbits not vaccinated with the bacterial products. However, the rabbits vaccinated with the lipopolysaccharide endotoxin preparations were significantly better protected than rabbits vaccinated with the bacterial proteases. Rabbits vaccinated with antisera raised against the proteases showed significantly less corneal damage than rabbits vaccinated with normal rabbit serum, and the passive protection was not significantly different than that elicited by active immunization against the bacterial proteases. The ability of the antiserum raised against the pseudomonas elastolytic protease to passively protect against severe corneal damage produced by experimentally induced pseudomonas keratitis was confirmed in mice. These findings support the idea that the bacterial endotoxins and proteases are virulence factors during the development of pseudomonas and serratia keratitis.
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PMID:Immunization against experimental Pseudomonas aeruginosa and Serratia marcescens keratitis. Vaccination with lipopolysaccharide endotoxins and proteases. 351 22


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