Microbiological Profile of Corneal Ulcers in Patients Who Consulted an Ophthalmological Center in Cartagena (2025)
This prospective study of 40 patients in Cartagena (2024–2025) reveals that infectious corneal ulcers are predominantly fungal in etiology, often associated with vegetative trauma, and characterized by low antimicrobial resistance, underscoring the need for empirical antifungal coverage and localized diagnostic strategies to improve clinical outcomes.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
The Big Picture: A "Forensic" Look at Eye Infections
Imagine the cornea (the clear window at the front of your eye) as a pristine glass pane. Sometimes, this glass gets scratched or damaged, allowing tiny invaders—bacteria or fungi—to sneak in and start a fire. This fire is called an infectious corneal ulcer. If not put out quickly, it can leave a permanent scar or even cause blindness.
This study is like a detective report from a specific eye clinic in Cartagena, Colombia. The researchers looked at 40 patients who came in with these "eye fires" between 2024 and 2025. Their goal was to figure out: Who got sick? What caused the fire? And how well did the "firefighters" (doctors) put it out?
The Suspects: Who Got Sick?
- The Crowd: Most of the patients were men (70%), and the average age was about 37. They were mostly from the city.
- The Cause of the Scratch: The biggest reason these eyes got infected was trauma (getting hit or scratched).
- Think of this like a car crash. The most common "crash" was hitting the eye with plant material (like a tree branch, a leaf, or a piece of straw). This happened in nearly half of the trauma cases.
- The second biggest cause was wearing contact lenses.
The Villains: What Was Inside the Eye?
The researchers took a tiny "swab" (like a Q-tip) from the eye to see what was growing. They found a germ in 75% of the cases. Here is the lineup of villains:
The Fungi (The Plant Invaders): These were the most common culprits in this specific group, making up 30% of all cases.
- The Analogy: If you get scratched by a dirty tree branch, you are likely to get a fungal infection. It's like getting a splinter that brings mold spores with it.
- The Star Villain: A specific type of fungus called Fusarium was the most common offender.
- The Behavior: These fungal infections were the "heavy hitters." They tended to be bigger, deeper, and more aggressive, often causing a buildup of pus (hypopyon) inside the eye.
The Bacteria (The Contact Lens Crew):
- The Analogy: If you wear contact lenses, the enemy is usually bacteria. It's like leaving a dirty dish in the sink; bacteria love the environment created by lenses.
- The Star Villains: Pseudomonas (a tough gram-negative bacteria) and Staphylococcus (a gram-positive bacteria).
- The Behavior: These infections were generally smaller and less deep than the fungal ones, but they still needed serious attention.
The Weapons: Did the Medicine Work?
The doctors treated the patients with eye drops.
- The Resistance Check: The researchers checked if the bacteria were "superbugs" (resistant to medicine). The good news? The bacteria in this group were mostly sensitive to standard antibiotics. Only a small handful (about 16% of the bacteria found) were resistant to common drugs like penicillin or quinolones.
- The Strategy Shift: At first, doctors often used a "shotgun approach," giving patients a mix of antibiotics, antiseptics, and antifungals just to be safe. Once the lab results came back (telling them exactly which villain was there), they switched to a "sniper approach," using only the specific medicine needed. This helped avoid overusing drugs.
The Aftermath: Scars and Sight
- The Scars: The most common result after the infection was cured was a corneal scar (leukoma). Imagine the glass window getting cloudy or frosted over. This happened in 65% of cases. Even though the infection was gone, the view was often blurry.
- Who Saw Better? Patients with bacterial infections generally had better vision at the start and recovered better than those with fungal infections. The fungal cases were tougher, often requiring surgery (like a "patch" called a conjunctival flap) to save the eye.
The Main Takeaway
The study concludes that in Cartagena, how you get hurt tells you what kind of germ you have.
- If you get hit by a plant, suspect fungus (and treat it with antifungal medicine).
- If you wear contacts, suspect bacteria (and treat it with antibiotics).
The researchers suggest that doctors in this region should keep this "rule of thumb" in mind when starting treatment, rather than guessing. By knowing the local "enemy" profiles, they can pick the right weapon faster, potentially saving more eyes from permanent damage.
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