Global Burden, Risk Factors, Causative Organisms and Antibiotic Susceptibility Patterns in Bacterial Keratitis
Abstract
Summary:
Background: Bacterial keratitis (BK) is a leading cause of corneal ulceration and vision loss worldwide. We aimed to synthesize global data on BK prevalence, risk factors, causative pathogens, and antibiotic susceptibility through a systematic review and meta-analysis.
Methods: This review (PROSPERO CRD420251088592) searched PubMed, Scopus, Cochrane CENTRAL, and PsycINFO through July 1, 2022, for observational studies of microbiologically confirmed infectious keratitis. Eligible studies reported numbers of BK cases and bacterial antibiotic susceptibility. Two reviewers screened studies and extracted data. The primary outcome was the pooled proportion of keratitis cases attributable to bacteria (random-effects meta-analysis); reported risk factors and susceptibilities were summarized descriptively.
Results: Of 5,180 records screened, 58 studies (>127,000 patients) met inclusion criteria. The pooled BK prevalence was 44% (95% CI 39–49%) with high heterogeneity (I²≈97%); prevalence varied by region (e.g. ∼61% in Oceania vs ∼29% in Africa). Among ∼25,000 bacterial isolates, 72% were Gram-positive. The most common species were Staphylococcus epidermidis (∼15%), Streptococcus pneumoniae (∼13%), Staphylococcus aureus (∼10%), and Pseudomonas aeruginosa (∼17%). Reported predisposing factors included trauma (∼44% of cases) and contact lens wear (∼23%). Gram-positive bacteria were >95% susceptible to vancomycin; Gram-negatives were >90% susceptible to aminoglycosides and…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 127,000 participants or records.
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