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Master Thesis

Épidémiologie des abcès de cornée hospitalisés au CHU de Montpellier entre 2010 et 2019

Abstract : Purpose: analyze the evolution of the microbiological profile of infectious keratitis, risk factors and prognosis outcomes in hospital of Montpellier between 2010 and 2019. Assess the seasonality of corneal abscesses. Design: cohort study. Methods: retrospective epidemiological study of corneal abscesses hospitalized at the Montpellier University Hospital between january 2010 and december 2019. A composite criterion of poor prognosis was considered if the final visual acuity at 3 months was greater than 2.0 logMAR or the need for surgery during the admission or after (GMA, Keratoplasty, enucleation, evisceration). We performed logistic regression to assess prognostic factors. Main outcome measures: 10-year microbiological profile, associated risk factors and prognostic factor for infectious keratitis. Results: 898 eyes presenting a corneal abscess with microbiological samples (mean age, 51.3 years; 47.8% women), presenting criteria for hospitalization, were included. A total of 533 were culture positive (59.3%), of which 497 identified a bacterium (including 36.8% pseudomonas aeruginosa), 16 a fungal infection and 6 an amoebic infection. The main risk factor found was wearing contact lenses (48.7%) followed by a history of eye surgery (25.7%), blepharitis (21.4%) of treatment with a local corticosteroid (17.6%) then an ocular trauma (11.2%). In multivariate, the factors of poor prognosis were age ≥50 years (p <0.0001), a post-surgical cause (p <0.0001), a surface pathology (p <0.0001) or systemic (p =0.003) and fungal infection (p =0.01). Contact lens infections had a better prognosis (p <0.0001), were associated with pseudomonas (p <0.0001) and age <50 years (p <0.001). There is a predominance of abscesses under lenses in summer (p <0.0001). Conclusion: we have observed a significant predominance of bacterial abscesses over the past 10 years at the Montpellier University Hospital, mainly occurring under contact lenses. The factors of poor prognosis highlighted in this study should alert the practitioner and prompt urgent treatment in the presence of one of these factors.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03158277
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Submitted on : Wednesday, March 3, 2021 - 5:00:07 PM
Last modification on : Monday, October 11, 2021 - 1:25:03 PM

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Chloé Martinot. Épidémiologie des abcès de cornée hospitalisés au CHU de Montpellier entre 2010 et 2019. Médecine humaine et pathologie. 2020. ⟨dumas-03158277⟩

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