J Korean Ophthalmol Soc > Volume 60(10); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(10):935-945.
DOI: https://doi.org/10.3341/jkos.2019.60.10.935    Published online October 15, 2019.
Clinical Analysis of Staphylococcus Keratitis According to Coagulase Positivity.
Namhyeon Choi, Chan Ho Cho, Sang Bumm Lee
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. sbummlee@ynu.ac.kr
혈장응고효소 양성 여부에 따른 포도알균 각막염의 임상 분석
최남현 · 조찬호 · 이상범
영남대학교 의과대학 안과학교실
Correspondence:  Sang-Bumm Lee, MD, PhD
Email: sbummlee@ynu.ac.kr
Received: 28 March 2019   • Revised: 2 May 2019   • Accepted: 24 September 2019
Abstract
PURPOSE
To analyze clinical aspects in a cohort of patients with Staphylococcus keratitis according to coagulase positivity (coagulase negative Staphylococcus [CNS], coagulase positive Staphylococcus [CPS]). METHODS: Epidemiology, predisposing factors, clinical characteristics, treatment outcomes, and antibiotic susceptibility were comparatively analyzed in 138 cases of culture-proven Staphylococcus keratitis (94 eyes with CNS and 44 eyes with CPS) over 20 years (1998–2017) at Yeungnam University Hospital. Poor clinical outcomes were defined as a final corrected visual acuity <0.1, a decreased visual acuity after treatment, complications, or surgical treatment. Risk factors for poor clinical outcomes were evaluated in the total cohort and analyzed using multivariate logistic regression. RESULTS: The most common predisposing factors were corneal trauma in the CNS group (47.9%) and previous ocular surface disease in the CPS group (31.8%). No significant differences were observed in mean age, sex, previous ocular surface disease, epithelial defect size, and hypopyon between the two groups. Methicillin susceptibility (39.4% vs. 72.7%, p < 0.001) was significantly lower in the CNS group, and poor clinical outcomes (28.0% vs. 43.9%, p = 0.076) were more common in the CPS group. The significant risk factors for poor clinical outcomes were initial best-corrected visual acuity <0.1, epithelial defect size ≥ 5 mm², symptom duration ≥10 days, and hypopyon. CONCLUSIONS: No significant differences were observed in epidemiological factors and initial clinical characteristics between the two study groups, but predisposing factors and methicillin susceptibility differed between the two groups. Treatment outcomes were relatively worse in the CPS group than in the CNS group, but the difference was not statistically significant. Poor clinical outcomes were more associated with long symptom duration and poor initial clinical characteristics than with coagulase positivity.
Key Words: Antibiotic susceptibility;Coagulase;Keratitis;Staphylococcus


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