Bacterial and fungal profile of corneal ulcers--a prospective study (original) (raw)
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Corneal ulcer: A prospective clinical and microbiological study
International Journal of Medical Science and Public Health, 2014
Background: It is important to study the epidemiologic features and predisposing factors of corneal ulcer and subsequently to find out its causative agents and their antimicrobial susceptibility patterns in a given community, climate and culture. Aims & Objectives: This prospective study of 100 cases of corneal ulcer was undertaken to bring out the bacterial and fungal prevalence among different age groups. Materials and Methods: Corneal scrapings were collected from all patients. One corneal swab and three corneal scrapings were collected. Direct examination of samples was done by potassium hydroxide wet mount and gram stained smear and then inoculated onto blood agar, MacConkey's agar and Saboraud's dextrose agar media. Identification of fungal growth finally was done based on its macroscopic and microscopic features. Bacterial colonies were identified by Gram staining and standard biochemical tests and antimicrobial susceptibility testing was carried out for each bacterial isolate. Results: Out of total 100 specimens of corneal ulcer, only 55% cases were found to be culture positive in which bacteria were more frequently isolated than fungi. Staphylococcus aureus and Aspergillus spp were the most frequent bacterium and fungus. The incidence was higher in males and in age group of >40-60 years. While S. aureus was found to be most sensitive to vancomycin, Staphylococcus epidermis was most sensitive to cefazoline. Conclusion: S. aureus and Aspergillus spp were the most common isolate to be associated with corneal ulcer, and the incidence was higher in rural population, especially farmers, who were constantly exposed to vegetative matter.
To Study the Causative Organism of Corneal Ulcer in a Tertiary Care Hospital
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Early microbiological examination and treatment of corneal ulcer will prevent further permanent ocular damage in the form of loss of vision and other abnormalities. Aim is to study the common predisposing factors, isolate and identify the bacteria and fungi responsible for the corneal ulcer, and the drug sensitivity pattern of isolated bacteria to the commonly used antibiotics in a tertiary care hospital. MATERIALS AND METHODS In a cross-sectional study, fifty patients of established corneal ulcer were examined, microbiological study carried out and common predisposing factors studied during the period of November 2013 to October 2015 in a government run tertiary care ophthalmic teaching hospital. RESULTS 66% cases were found culture positive of which 40% were bacteria, 16% were fungal and 10% were mixed infection. Staphylococcus aureus was the predominant bacterial isolate and Aspergillus species was the commonest fungal isolate. Males and females were equally affected. The highest incidence of bacterial keratitis and mycotic keratitis were 68% (17/25) and 38.6% (5/13) respectively in the age group of 41-50 years. Farmers were commonly affected due to trauma during the harvesting season of December to February. Six cases (46%) of fungus positive cases were associated with trauma due to paddy leaf. Most of the organisms were sensitive to moxifloxacin, ofloxacin, amikacin and vancomycin. CONCLUSION Corneal ulcer was commonly found in the adults and more so among the low socioeconomic group and in the rural areas where cultivators were more prone to develop corneal ulcer due to trauma during the harvesting season. Staphylococcus aureus and Aspergillus were the commonest pathogenic organisms. Fluoroquinolone appeared to be the therapy of choice for bacterial keratitis with moxifloxacin as the most sensitive antibiotic.
Journal of Ophthalmology, 2021
Background. A corneal ulcer is a major cause of monocular blindness in developing countries, including Ethiopia. Its etiology varies based on its geographical location and climatic conditions. erefore, the main objective of this research was to assess the clinical and microbiological profile of suspected bacterial and fungal corneal ulcers at the Tertiary Eye Care and Training Centre at Gondar University. Methods. A cross-sectional hospital-based study of corneal ulcer cases was performed from February to October 2019. Sociodemographic and clinical data were collected using a standardized questionnaire. Corneal scrapings were used to classify bacterial and fungal pathogens. e specimens were inoculated on BHI media and sub-cultured on culture media for the separate cultivation of bacteria and fungi. Biochemical tests have been carried out to classify bacteria. Following CLSI, the antimicrobial resistance pattern of bacterial isolates was carried out. Wet mounting, Lactophenol cotton blue staining, and colony characteristics on SDA were used to classify fungal species. e data were analyzed with version 20 of the SPSS. Results. A total of 30 suspected bacterial and fungal keratitis patients have been enrolled in this study. e visual acuity presented in 90% of the affected eyes was in the category of blindness (<3/60). In 71% of the cases, clinically presumed risk factors were identified. Trauma was the most common risk factor found in 46% of cases, followed by keratitis exposure (13%). Of the corneal scrape tests, 76.6% were positive for bacteria and fungi. Fungi were identified in 53.3% of corneal ulcers followed by 33.3% of bacterial growth. e commonest fungi and bacteria isolated were Aspergillus species (69%) and S. aureus, respectively. e prevalence of Methicillinresistant S. aureus (MRSA) was 2 (40%). e identified Pseudomonas species were susceptible to Gentamicin and Ciprofloxacin but resistant to Ceftriaxone. Conclusion. e primary microbial agents for corneal ulcers were fungi, and trauma was the most significant risk factor associated with corneal ulcers. To avoid chronic ocular morbidity and blindness, early identification of the etiologic agent and the provision of adequate management are recommended.
A study on various pathogens causing corneal ulcers and their susceptibility to antibiotics
IOSR Journal of Dental and Medical Sciences, 2016
Introduction: Corneal ulcer is one of the most common causes of preventable blindness especially in developing countries like India. Cataract and corneal diseases are major causes of blindness in countries with lessdeveloped economies. According to the World Health Organization, corneal diseases are among the major causes of vision loss and blindness in the world today, after cataract and glaucoma. As the corneal ulcer is the leading cause of this problem this study has been taken up to go into the details of etiology and incidence of various organisms causing corneal ulcers. Methodology: This was a longitudinal study conducted at Ophthalmology OPD, Dr PSIMS & RF, Gannavaram. 100 Patients having corneal ulcer were included as study participants. Most of the cases admitted were between age groups 11-80. Children below the 10 years age group were excluded from the study. Results: It was found that bacterial ulcers were common and accounted for 56% of the cases. Fungal ulcers accounted for 20% of all the cases and NBG group were 14%. Sterile cultures are due to the fact that the patient comes to the department after using antibiotics. Straphylococcus epdermidis was a commonest organism to cause an ulcer in compromised, malnourished and patient on steroids. The majority of fungal ulcers were due to direct injury to the eye with vegetable matter. Among the fungal ulcer, aspergillus fumigatus was commonest. The sensitivity found among isolated is highest with Gatifloxacin, Ciprofloxacin, Tobramycin and Gentamycin. Conclusion: Earlier the diagnosis and treatment based upon investigations, the cure rate of corneal ulcer are maximal.
Clinical and microbiological spectrum of corneal ulcer in eastern region of Uttar Pradesh
IP innovative publication pvt. ltd, 2019
Aim: To find clinical microbiological spectrum and predisposing factors of corneal ulcer in eastern Uttar Pradesh. Materials and Methods: This was a hospital based prospective study conducted in Regional Institute of Ophthalmology, IMS, BHU, Varanasi, over a period of three years from May 2015 to April 2018.Suspected microbial keratitis were stained with fluorescent paper strip and examined under cobalt blue light. Scraping of the edge and bases were directly inoculated on Sabouraud’s Dextrose Agar and Blood Agar. Plates were examined daily in 1st week then every 3rd day for next 3 weeks. Results: Maximum cases were seen in the age group of 25-50 years (63.79%), with male preponderance (60.30%). Trauma to the affected eye was major predisposing factor for microbial keratitis (74.10%). The major etiological agent in our study was fungal corneal ulcers followed by bacterial ulcer. Aspergillus spp. (53.84%) was most common filamentous fungi followed by Fusarium spp. (23.07%). Among bacteria most common species was Staphylococcus aureus 57.89% followed by Streptococcus pneumoniae and Pseudomonas aeruginosa present in 21.05% and 15.78% respectively. Conclusions: The major aetiological agent in our study was fungal corneal ulcers followed by bacteria ulcer. Filamentous fungi were most common cause of fungal corneal ulcer with Hyaline fungi (80.76%) and Phaeoid fungi (11.53%).
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.7\_July2021/IJRR-Abstract032.html, 2021
Background-Visual impairment due to corneal ulceration has for long been acknowledged as leading cause of blindness both worldwide and in India only next to Cataract. The aetiology for infective corneal ulcer varies considerably with occupation of patients in different regions of India. Thus, continuing with empirical management without lab diagnosis leads to protracted clinical course. So, understanding the microbial profile of corneal ulcers in agriculture dependent population of Southern Assam helps in improved management of this morbidity. Aims- To 1) Find the prevalence of infected corneal ulcers in untreated patients attending Ophthalmology department of a tertiary care hospital of Southern Assam. 2) Study the pattern of microbial aetiology in the infected corneal ulcer cases. 3) Find the association of infected corneal ulcers with various attributing factors. Method-Corneal scrapings from 86 routine untreated cases of corneal ulceration from Ophthalmology Department were studied prospectively from Dec2017 to Jan2019 and subjected to Gram staining and direct examination with 10%KOH. Culture on SDA and Blood Agar were incubated at 25°C and 37°C respectively and followed up for 3 weeks before declaring sterile. Antimicrobial sensitivity was performed for bacterial isolate and yeast-like species. Slide culture and LPCB tease mount were done for identification of moulds. Result- Out of the 86 cases, 58 were positive in direct microscopy, of which 44 were culture positive. Of the 28 samples negative in direct microscopy, 2 were positive by Culture. Bacterial isolates were found in 5 cases and fungal aetiology in 41 cases. Conclusion- The prevalence of infected corneal ulcer as per standard of Culture positivity is 53.5% (46/86). Mycotic involvement was found in 90% cases. Important fungal isolates identified were Aspergillus species, Penicillium species, Curvularia species, Fusarium species, Sarocladium species. Higher prevalence was significantly associated with harvesting season, agricultural practice and history of trauma while diabetes and steroid intake were not significantly associated with mycotic ulcers.
Microbiological Profile of Corneal Ulcers at a Tertiary Referral Center
Medical Hypothesis, Discovery and Innovation in Ophthalmology, 2019
The aim of this study was to describe patient demographics, microbiological profile, and antibiotic susceptibility of corneal ulcer at a tertiary referral center to improve and optimize diagnosis and treatment of this potentially blinding entity and to reduce antibiotic misuse. Detailed external and slit-lamp bio-microscopic examination of 123 consecutive patients with suspected corneal ulcer was performed at an ophthalmology clinic. Corneal scraping was carried out under slit-lamp bio-microscopy. The obtained material was inoculated on culture media and smeared on a slide for Gram's staining for morphological identification of bacteria and fungus. For samples that developed colony in culture media, antibiotic susceptibility testing was performed. In a significant percentage of patients (72%) neither bacterial agents nor fungi were the cause of corneal ulcer. Of the 34 culture-proven corneal ulcers, in 79% of the cases, bacteria were detected while in 21% of cases, fungi were fo...
Clinico-microbiological perspective of corneal ulcer
IP innovative publication pvt. ltd, 2019
Abstract Corneal ulcer is a major cause of mono-ocular blindness in developing countries. Clinical diagnosis and management of corneal ulcers is helped by microbiological diagnosis. Purpose: To evaluate microbiological support for clinical diagnosis and management of corneal ulcers. Materials and Methods: All the patients presenting with corneal ulceration underwent clinical evaluation and standard microbiological evaluation of their corneal scrapings. Results: Out of 200 corneal ulcer cases, 127 were clinically diagnosed as bacterial and 73 as fungal. On microscopy 65 were positive for Gram’s staining, 49 were stained by KOH staining and rest 86 were negative for Gram’s and KOH staining. Further culture examination of total corneal cases identified 69 bacterial isolates and 50 fungal isolates. Conclusion: A good clinical evaluation aided by microbiological support will help in better diagnosis and treatment of corneal ulcer. Keywords: Clinically diagnosed, Corneal ulceration.
Microbiological study in cases of corneal ulcer and clinical outcome
IP Innovative Publication Pvt. Ltd, 2017
Introduction: Cornea is anterior transparent layer of eye and important for image formation. Keratitis (corneal inflammation) and resulting corneal ulcer is important clinical challenge in ophthalmology. Prompt treatment requires identification of organism involved. Insight regarding types of organisms involved, patient demography, antibiotic sensitivity greatly helps in better patient management. Materials and Methods: Patients with clinical diagnosis of 'Corneal ulcer', attending Department of Ophthalmology GMERS Medical College, Gandhinagar were selected for this observational study. Total 79 patients were studied. Detailed history and ocular examination were undertaken for each patient. Corneal scrapings from corneal ulcer were taken for pathological and laboratory study to identify type of organism and its antibiotic sensitivity. Data was arranged in tables for analysis. Diverse types of organisms and their frequency of occurrence was calculated. Patients were selected as per predefined criteria. Study recruitment was done after informed consent. Institutional ethics committee clearance was obtained. Discussion: Corneal ulcer is important and serious ophthalmic problem contributing to significant portion of total blindness burden in our country. Understanding types and varieties of organisms gives insight regarding local community conditions. Antibiotic sensitivity study gives accurate guideline regarding precise use of antibiotic thereby shortening treatment period and minimizing antibiotic resistance. Comparison about various similar studies were carried out to elucidate findings. Results: Patient demographics tables and graphs were prepared and analysis presented.