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2003 OMIG, Abstract 8

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Serratia Corneal Ulcers: A Retrospective Clinical Study
Jeane Haidee Mah-Sadorra, Dany M. Najjar, Christopher J. Rapuano, Peter R. Laibson, Elisabeth J. Cohen.
Cornea Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.

Objective: To study the clinical and microbiological profile of Serratia corneal ulcers at the Cornea Service of the Wills Eye Hospital.
Design: Retrospective, observational case series.
Participants: The clinical reads of all patients with Serratia marcescens corneal ulcers seen at the Cornea Service of the Wills Eye Hospital between January 1, 1998 and December 31, 2002 were reviewed.
Results: During this 5-year period, 475 consecutive corneal ulcers were seen. Cultures were obtained In 372 eases (78%) and a pathogen was recovered in 271 cultures (73%). Serratia marcescens was isolated in 21 cultures (7.7%) in 18 patients. Two patients (11%) had recurrent keratitis. Five patients (28%) were contact lens wearers. Eleven patients (61%) had the Serratia ulcer in a corneal graft, four (22%) of which were associated with suture infiltrates. The Serratia infection in thirteen patients (72%) was associated with an abnormal corneal surface. Thirteen patients (72%) were on topical medications -13 used corticosteroids and 11 had anti-glaucoma drops. All of the isolates were sensitive to ciprofloxacin and ofloxacin. Sixteen patients responded to medical therapy. One patient underwent evisceration for corneal perforation and the other patient underwent a repeat penetrating keratoplasty for severe graft ectasia in the area of the ulcer.
Conclusion: Serratia marcescens keratitis is associated with contact lens wear, abnormal corneal surface, corneal grafts, and use of topical medications. In general, Serratia corneal ulcers have a good response to medical therapy including the topical fluoroquinolones.

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