Microbial Keratitis in Cairo University Hospitals

Incidence, Risk Factors and Microbiological Features of Infective Keratitis in Cairo University Hospitals

The aim of the study was to identify the incidence of infective keratitis presenting to the ophthalmology emergency department at Cairo University hospital, the risk factors and the bacterial/fungal spectrum causing the ulcers and to determine the best possible empirical therapy followed by specific therapy after obtaining culture results.

Study Overview

• Status: Completed
• Conditions: Infective Keratitis

• Study Type: Observational
• Enrollment (Actual): 85

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11562
    • Kasr Al Aini Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Recruitment occurred from the Ophthalmology outpatient clinics and casualty department in Cairo University Hospitals, Kasr Al Aini.

They met all inclusion and exclusion criteria for enrollment into this study.

Description

Inclusion Criteria:

• Patients presenting at the casualty who are clinically diagnosed as infectious keratitis , of all age groups and including both genders.

Exclusion Criteria:

Patients presenting with clinical picture suggestive of

• Viral keratitis solely without superimposed secondary infection.
• Non infectious keratitis as peripheral ulcerative keratitis ( e.g. Mooren's ulcer, marginal keratitis, autoimmune keratitis )

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Cross-Sectional

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To identify risk factors and the most common causative organisms of microbial keratitis among the Egyptian population through history taking from each patient and the results of corneal sampling taken from the ulcer.	Thorough history taking including risk factors that contributed to the ulcer occurrence. Corneal sampling through corneal scraping from the base and edge of the ulcer that undergoes direct examination and culturing using standard laboratory protocols.	Three weeks for each participant
To detect incidence of infective keratitis amongst all ophthalmological casualty cases by documenting the number of cases presenting or referred to the casualty of the ophthalmology department.	Noting down the number of patients diagnosed with microbial keratitis that present to the casualty of a tertiary referral hospital, and calculate the percentage amongst all other ophthalmic casualty cases that present to the emergency as well.	through study completion, an average of eight months
To detect antimicrobial susceptibility and resistance of different antimicrobial agents causing corneal infections in our study group.	Antibiotic susceptibility testing was performed by the disc diffusion method (Modified Kirby Bauer technique) using Muller Hinton agar, aerobic incubation at 35°C for 16-18 hours. Anti fungal susceptibility was done using microdilution testing following the CLSI reference method.	two weeks for each participant

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess the impact of culture and sensitivity results of corneal scrapings on the initial empirical therapy by calculating the number of cases that needed to shift the initial therapy to another one according to the antimicrobial susceptibility.	Empirical therapy according to the clinical impression that was shifted to another therapy according to the specific sensitivity results of positive growth cases.	six months
Improving lines of management of microbial keratitis for a better outcome based on the cooperation between clinical ophthalmologists and microbiologists to reach a proper diagnosis and tailor the management accordingly.	Clinical impression of the nature of microbial keratitis , combined with the results of corneal scrapings positive growth cultures to detect the proper management plan for each patient to increase the chances of healed ulcers with medical therapy. Calculating the number of improving, healed and complicated cases.	six months

Collaborators and Investigators

• Sponsor: Kasr El Aini Hospital
• Investigators: Study Chair: Yehia Mostafa, MD, Kasr Al Aini Hospital; Study Director: Mohamed El Agha, MD, Kasr Al Aini Hospital; Study Director: Ihab Othman, MD, Kasr Al Aini Hospital; Study Director: Moushira Hosny, MD, Kasr Al Aini Hospital; Principal Investigator: Nevien Lotfy, MSc, Kasr Al Aini Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 10, 2020
• Primary Completion (Actual): May 30, 2021
• Study Completion (Actual): June 15, 2021

Study Registration Dates

• First Submitted: May 17, 2022
• First Submitted That Met QC Criteria: May 20, 2022
• First Posted (Actual): May 24, 2022

Study Record Updates

• Last Update Posted (Actual): May 24, 2022
• Last Update Submitted That Met QC Criteria: May 20, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Keywords: Corneal ulcer; Microbiological profile; Fungal keratitis; Bacterial keratitis; Infective keratitis; Antimicrobial susceptibility
• Additional Relevant MeSH Terms: Eye Diseases; Corneal Diseases; Keratitis
• Other Study ID Numbers: MS-427-2020

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: all IPD that underlie results in a publication.
• IPD Sharing Time Frame: After being published.
• IPD Sharing Supporting Information Type: Study Protocol

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No