Severe Infectious Keratitis Among Inpatients at an Emergency Tertiary Hospital Ophthalmology Department in France: Associations Between Known Predisposing Factors and Patient Demographic, Clinical, and Microbiological Characteristics

Objectives: Describe the epidemiological, clinical, and microbiological patterns in severe infectious keratitis (IK) and identify variables associated with known risk factors. Methods: We retrospectively reviewed inpatient hospitalizations for severe IK (2016–2021) in our tertiary emergency ophthalmology department (France). Chi-squared and Student's t-tests compared demographic, clinical, and microbiological variables according to the presence of known risk factors. Associations between known risk factors (model outcomes) and our chosen variables (predictors) were analyzed by multivariate logistic regression. Results: A total of 861 participants were included (mean age 56 years, 50.3% female) among which 96.2% harbored ≥1 risk factor. Contact lens wear (32.2%) and ocular trauma (14.3%) were the most common risk factors. Contact lens wear–related IK was associated with female sex ( adj OR2.91 [2.08–4.10]; P =0.0001) and younger age (56 years and younger) ( adj OR7.81 [5.50–11.2]; P =0.0001), whereas ocular trauma–related IK was associated with male sex ( adj OR4.55 [2.86–7.14]; P =0.0001) and younger age ( adj OR1.65 [1.10–2.49]; P =0.017). Contact lens wear–related ( adj OR1.97 [1.38–2.82], P =0.0002) and anterior segment surgery–related ( adj OR1.74 [1.07–2.79]; P =0.02) IK were associated with summer admission. Contact lens wear was associated with gram-negative bacilli infection ( adj OR4.32 [2.9–6.46]; P =0.0001). Conclusions: Prevention strategies are required for younger female contact lens users, patients undergoing anterior segment surgery in summer, and younger men with ocular trauma.