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Abstract
This study investigated Staphylococcus aureus carriage in patients with microbial keratitis (MK). 215 patients with MK, 60 healthy controls and 35 patients with rheumatoid arthritis (RA) were included. Corneal scrapes were collected from patients with MK. Conjunctival, nasal and throat swabs were collected from the non-MK groups on a single occasion and from the MK group at presentation and then at 6 and 12 weeks. Samples were processed using conventional diagnostic culture. 68 (31.6%) episodes of clinically suspected MK were classed as recurrent. Patients with recurrent MK had a higher isolation rate of S. aureus from their cornea than those with a single episode (p < 0.01) and a higher isolation rate of S. aureus from their conjunctiva compared to control participants, 20.6% (14/68) versus 3% (5/60) respectively (p = 0.01). Significantly more patients with recurrent MK (12/68, 17.6%) were found to have S. aureus isolated from both their conjunctiva and nose than those with a single episode of MK (7/147, 4.8% p = 0.002) and compared to patients in the control group (3/60, 5.0% p = 0.03). The results indicate that patients with recurrent MK have higher rates of carriage of S. aureus suggesting endogenous site colonisation as a possible source of recurrent infection.
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1 University of Liverpool, Department of Eye and Vision Sciences, Liverpool, UK (GRID:grid.10025.36) (ISNI:0000 0004 1936 8470); The Royal Liverpool University Hospital, St Paul’s Eye Unit, Liverpool, UK (GRID:grid.415970.e) (ISNI:0000 0004 0417 2395)
2 The Royal Liverpool University Hospital, St Paul’s Eye Unit, Liverpool, UK (GRID:grid.415970.e) (ISNI:0000 0004 0417 2395)
3 The Royal Liverpool University Hospital, Department of Microbiology, Liverpool, UK (GRID:grid.415970.e) (ISNI:0000 0004 0417 2395)
4 University of Liverpool, Department of Infection Biology and Microbiomes, Liverpool, UK (GRID:grid.10025.36) (ISNI:0000 0004 1936 8470)