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Purpose <p>To correlate clinical outcomes of fungal keratitis with in vitro antifungal susceptibility profiles.</p> Methods <p>This retrospective case series included microbiologically confirmed fungal keratitis cases treated with antifungals for ≥ 1&#xa0;week (August–December 2022). Cases with early therapeutic penetrating keratoplasty (TPK) (&lt; 1&#xa0;week) or mixed etiology were excluded.</p> Results <p>Records of 83 patients were reviewed. Medical cure was achieved in 48 (57.8%) patients, while 35 (42.2%) underwent TPK. <i>Fusarium</i> sp.(41%) and <i>Aspergillus</i> sp<i>.</i>(33.7%) were most prevalent. Several other fungi were isolated like <i>Curvularia</i>, <i>Acremonium</i>, <i>Lasiodiplodia</i>, etc. (25.3%). <i>Fusarium</i> showed lower natamycin resistance (35.3%) than <i>Aspergillus</i> (50%) (<i>p</i> = 0.2429)&#xa0;species; but higher resistance to voriconazole, itraconazole, and posaconazole (V, 82.4%; I, 66.7%; P, 82.4%) versus <i>Aspergillus</i> (V, 39.3%; I, 26.9%; P, 32.1%) (<i>p</i> &lt; 0.005). Among cases with milder severity (infiltrate &lt; 4&#xa0;mm) (n = 40), higher natamycin resistance was associated with greater&#xa0;rate of TPK (60%) versus medical resolution (26.7%) (<i>p</i> = 0.123).</p> Conclusion <p>Although the outcomes are multifactorial, antifungal resistance seems to influence the prognosis of fungal keratitis.</p>

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Fungal keratitis: Does antifungal Resistance Influence the outcome?

  • 期刊论文

  • 发表日期：

    2025年11月24日

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  • Pratima Vishwakarma,
  • Lakshminarayanan Gowtham,
  • Esther Sheba,
  • Joveeta Joseph,
  • Bhupesh Bagga

摘要

Purpose

To correlate clinical outcomes of fungal keratitis with in vitro antifungal susceptibility profiles.

Methods

This retrospective case series included microbiologically confirmed fungal keratitis cases treated with antifungals for ≥ 1 week (August–December 2022). Cases with early therapeutic penetrating keratoplasty (TPK) (< 1 week) or mixed etiology were excluded.

Results

Records of 83 patients were reviewed. Medical cure was achieved in 48 (57.8%) patients, while 35 (42.2%) underwent TPK. Fusarium sp.(41%) and Aspergillus sp.(33.7%) were most prevalent. Several other fungi were isolated like Curvularia, Acremonium, Lasiodiplodia, etc. (25.3%). Fusarium showed lower natamycin resistance (35.3%) than Aspergillus (50%) (p = 0.2429) species; but higher resistance to voriconazole, itraconazole, and posaconazole (V, 82.4%; I, 66.7%; P, 82.4%) versus Aspergillus (V, 39.3%; I, 26.9%; P, 32.1%) (p < 0.005). Among cases with milder severity (infiltrate < 4 mm) (n = 40), higher natamycin resistance was associated with greater rate of TPK (60%) versus medical resolution (26.7%) (p = 0.123).

Conclusion

Although the outcomes are multifactorial, antifungal resistance seems to influence the prognosis of fungal keratitis.