COVID-19 Has Reduced Presentation Rates for Microbial Keratitis, Study Reveals

A recent study has revealed that coronavirus disease or COVID-19 has reduced presentation rates for microbial keratitis or MK and changed the spectrum of isolated cultures; however, no clear impact on results.

COVID-19 Has Reduced Presentation Rates for Microbial Keratitis, Study Reveals
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What Is Microbial Keratitis?

Microbial Keratitis or most commonly known as Bacterial Keratitis – is an infection of the cornea, the clear dome that covers the colored part of the eye, that is caused by bacteria.

This usually happens due to improper care and cleaning of contact lenses or from injury to the cornea. This bacterial infection can affect those people who wear contact lenses, and also those people who do not even wear contact lenses. Certain types of bacteria that commonly cause microbial keratitis include; pseudomonas aeruginosa.

What Causes Microbial Keratitis?

Microbial Keratitis is usually caused by contact lens wear; however, infection of the cornea can also result from exposure of the eyes such as if the eyelids are not blinking normally, loss of sensation in the eye surface, injury or surgery, lack of tears or known as dry eyes, and in people whose immune system is not functioning properly.

How Is Microbial Dermatitis Treated?

Fortified antibiotics is the traditional therapy for microbial keratitis. Tobramycin (1mg/mL) 1 drop for every hour alternating with fortified cefazolin (50 mg/mL) or vancomycin (50mg/mL) 1 drop every hour.

How Common Is Microbial Dermatitis?

Microbial Keratitis is generally correlated with one or more of the following: wearing of contact lenses, particularly soft lenses that are worn overnight; incidence soft daily wear: 2-4 per 10,000 per year (0.02% - 0.04% per year), soft overnight wear 20 per 10,000 per year or 0.2% per year.

Medical records of suspected microbial keratitis (MK) patients, were retrospectively reviewed by experts, requiring corneal scrapes who presented between 23rd March and 30th June 2020. Results, isolates, medications, and concurrent conditions were compared with patients who presented in the equivalent time windows pre-COVID-19 in 2017, 2018, and 2019 respectively.

In total, 63, 50, and 68 patients who presented for microbial keratitis (MK) during 2017, 2018, and 2019. There were only 49 patients who did so during or at the onset of the pandemic, suggesting a slight decline in presentation rates. Likewise, the total attendances to the clinic plummeted from 12,128 and 12,239 in 2018 and 2019, correspondingly, to 5,759 in 2020. The proportion of MK presentations, in turn, increased significantly from 0.5% pre-COVID-19 to 0.9% at the height of the pandemic.

Rate of culture positivity was comparable between the pre-COVID-19 and pandemic eras; however, the distribution of culture isolates is different. Poly-microbial infection happened significantly more frequently before the pandemic, while the gram-negative mono-infections tended to be more predominant in year 2020.

Furthermore, regardless of comparable rates of disease severity, the rate of admission was significantly reduced during the pandemic era.

Researchers said that, “Increased handwashing practices, as well as changes in environmental factors, such as reduced contact lens wear, may have contributed to the findings, particularly the changes in microbial spectra. However, these findings must be validated on a larger scale.”

 

Source: PLoS One 2021;doi:10.1371/journal.pone.0256240

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