Clinico-Microbiological Profile of Infective Keratitis in a Tertiary Care Hospital, Eastern India (original) (raw)
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Bulletin of the National Research Centre
Background: Corneal ulcer is a potentially sight threatening ocular condition and the leading cause of monocular blindness in developing countries. Knowing the predisposing factors and etiologic microorganism can help prompt diagnosis and treatment to prevent devastating outcomes The aim of this study was to detect the prevalence of bacteria and fungi in infectious keratitis. And to detect the antimicrobial susceptibility pattern against these causative bacterial and fungal pathogens using antibacterial and antifungal disces. Results: Out of 50 cases (= 50 eyes), fungal growth was predominant 23/50 representing 46% with Aspergillus flavus being the most prevalent 14/23(61%). Bacterial growth was 7/50 (14%), 4/7 was gram-positive cocci (Staphylococcus aureus and Streptococcus pneumonie) and 3/7 was pseudomonas spp. While twenty out of 50 cases (40%) showed no growth. Conclusion: Ocular trauma was the major cause of infectious keratitis, more in rural population. Fungal growth; mainly Aspergillus spp. was the most prevalent pathogen encountered in all cases. Voriconazole proved to be the first choice in the treatment of mould keratitis with 100% susceptibility. While alarmingly, fluconazole should no longer be used for the empirical therapy as it showed resistance to all the fungal isolates.
Clinical and microbiological profile of infective keratitis and their antibiotic sensitivity
IP Innovative Publication Pvt. Ltd., 2019
Introduction: Microbial keratitis is a common, potentially vision-threatening ocular infection that may be caused by bacteria, fungi, or parasites. Successful treatment of corneal ulcer requires proper diagnosis and early institution of intensive therapy with appropriate antimicrobial agents. Aim: To determine specific pathogenic organism and clinical risk factors for infective Keratitis. Materials and Methods: Patient with clinical features of infective keratitis attending Ophthalmology OPD were included whose corneal scrapings were subjected to Gram staining, KOH Mount and culture sensitivity. Statistical analysis done by using appropriate statistical methods. Results: 40 cases were evaluated. 23 were males and 17 females. Age ranged from 21 to 70 years. History of trauma was present in 47.5% of patients, ocular surface disease was present in 10% while diabetes was present in 10% of patients. Based on culture reports, bacterial and fungal keratitis found in (65%) 26 patients. There was no organism isolated from rest of the 14 samples (sterile keratitis). Bacteria were isolated in 14 samples and in 12 samples fungal growth was isolated. The commonest bacterial isolate were Staphylococcus aureus followed by Pseudomonas, Coagulase negative staphylococcus and Klebsiella. Aspergillus species was isolated in 7 patients and fusarium species in 4 patients. Gram positive isolates were maximally sensitive to Ofloxacin, gram negative to Gentamicin. Conclusion: Staphylococcus aureus was the most common bacterium while Aspergillus was the most common fungus isolated. Trauma was the commonest risk factor for corneal ulcer. Keywords: Corneal ulcer, Staphylococcus, Aspergillus, Trauma, Culture.
IP Innovative Publication Pvt. Ltd., 2018
Introduction: Infectious keratitis is among the leading causes of preventable blindness in developing countries. The epidemiological profile of infectious keratitis vary significantly from country to country and even area to area within the same country. Aim: This study was conducted to know the epidemiological pattern, predisposing risk factors involved and microbiological profile of the patients with corneal ulcer. Materials and Methods: A retrospective analysis of all the patients presenting to MMIMSR eye opd with corneal ulcer between Jan 2016 to June 2018 was done. The demographic data as well as epidemiological profile including history of trauma, duration of symptoms, predisposing risk factors, time taken to present to hospital was collected. The diagnosis was made based on clinical findings on Slit lamp examination as corneal epithelial defect with stromal infiltrate and microbiological investigations. Results: There were a total of 234 patients documented to have corneal ulcer. The mean age of presentation was 46 ± 18 years. Only 20 (8.6%) presents within a week of symptoms and 122 patients (52.1%) presented within 2 to 4 week of symptoms. A history of ocular trauma was present in about 150 patients (64%) out of which trauma with vegetative matter in 88 (58.67%) patients and trauma with non vegetative matter in 51 (34%) patients. Corneal scrapping was positive in 185 patients (79.04%) with KOH mount being positive in 152 patients (64.95%). Gram stain was positive for bacteria in 21 patients (8.97%) and 12 (5.12%) patients reported both bacteria and fungus. In 47 patients (20.08%), no organism was reported. Among the gram positive isolates, Staphylococcus epidermidis was the most frequent species. The most common fungal isolate reported was fusarium in 49 patients (26.48%) followed by Aspergillus in 19 patients (10.27%). Conclusion: Infective keratitis is a common cause of ocular morbidity with fungal corneal ulcer being the most frequent ulcer. Fusarium species in fungal corneal ulcer and staphylococcal epidermidis in bacterial corneal ulcer were the common isolates. A lack of knowledge about the magnitude of the problem, financial limitations and topographical constrains were implicated in delayed presentation to a health center. Keywords: Corneal ulcer, Corneal opacification, Infective keratitis, Ocular trauma, Preventable blindness.
ETIOLOGICAL DIAGNOSIS OF MICROBIAL KERATITIS IN A TERTIARY CARE HOSPITAL IN GUJARAT
National Journal of Medical Research, 2013
Introduction: Blindness is a major public health problem worldwide, and infectious keratitis is one of the predominant causes. Ulcerative keratitis due to infection with a wide range of organisms such as viruses, bacteria, fungi or protozoa has been reported. Bacterial and mycological keratitis typically occurs in persons having some associated factors. Objectives: To analyze etiology and associated factors associated with microbial keratitis Materials and Methods: The study was conducted at the C. U. Shah Medical College and Hospital, Surendranagar, Gujarat. Total 100 samples from patients with corneal ulcers were studied during the month of December 2010 to October 2011. Swabs and scrapping from the corneal ulcer were collected aseptically. Staining and culture were performed as per standard guidelines. Bacterial and fungal species were isolated as per standard microbiological guidelines. Results: Out of 100 samples, in 14 (14.00%) samples fungal species were isolated and in 13 (13.00%) samples bacteria were isolated. Among 14 fungus isolates, 8 (29.63%) were Aspergillus flavus and 6 (22.22%) were Aspergillus niger. Among 13 bacterial isolates 7 (25.93%) were Pseudomonas species, 3 (11.11%) were Staphylococcus aureus and 3 (11.11%) were Coagulase negative staphylococci. Common associated factors were injury (44.45%), diabetes mellitus (29.63%), contact lens usage (14.82 %) and corticosteroid treatment (03.70%). Conclusions: Prevalence of mycological keratitis is 14.00% and bacterial keratitis is 13.00%. Common associated factors observed were injury, diabetes mellitus and contact lens usage.
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.3\_March2021/IJRR-Abstract037.html, 2021
Corneal ulcer is a leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcer and their prompt treatment helps to save the vision. A cross sectional study was conducted in Government Medical College, Kozhikode, between January 2016 to June 2017 to detect bacterial agents of corneal ulcer and determine the antibiotic susceptibility pattern of those isolates. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. Among the 120 cases, a total of 27 cases were culture positive. 21/120 [17.5%] were bacterial, 6/120 [5.0%] were polymicrobial and 22/120 [18.34%] were fungal. Among bacterial aetiology, Pseudomonas aeruginosa was most common [33.34%] followed by Coagulase negative Staphylococcus-22.23% and Streptococcus pneumoniae-18.51%. Trauma was the major risk factor. Diabetes mellitus, contact lens usage, exposure keratitis were the other comorbidity / risk factors. Out of the total 27 culture positive bacterial corneal ulcer cases none healed completely, 77.78% improved clinically with opacity and 22.22% ended with recurrence/complications. This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly due to bacteria. Corneal ulcers responded well to antimicrobials except a few complicated ulcers. Microscopy, culture and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment.
Epidemiological and microbiological profile of infective keratitis in Ahmedabad
Indian Journal of Ophthalmology, 2012
BACKGROUND Corneal ulcer is an open sore on cornea causing significant morbidity especially in developing countries. It is associated with redness, watering, photophobia, pain and decreased vision of that eye. It is a vision threatening emergency and may lead to corneal scarring and perforation. If left untreated it may progress to endophthalmitis. So, an early diagnosis with recognition of the causative agent is very much essential to preserve vision. We conducted this study to evaluate the risk factors, causative organisms, and patient demographics of microbial keratitis. METHODS All new patients with suspected suppurative keratitis presenting at the ophthalmology OPD of Calcutta National Medical College and Hospital for a period of 1 year were evaluated. Sociodemographic data, visual acuity at presentation, and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping was performed. Microscopy and culture were performed on all corneal specimens obtained. From this data we tried to find out the epidemiological pattern and factors involved in suppurative corneal ulcer. RESULTS One hundred and fifty cases of suppurative keratitis were studied clinically and microbiologically. Study showed a male preponderance (73.33%) with cultivators constituting the major occupational group (29.33%). Trauma was the commonest pre-disposing factor (64%). Among the 114 (76%) culture positive cases, 62 (41.33%) patients had pure fungal infection, 33 (22%) patients had pure bacterial infections and 19 cases (12.67%) had mixed fungal and bacterial infections. Aspergillus spp. were the most common fungal isolate, while among the bacteria positive cases, the main isolates were Staphylococcus aureus, Pseudomonas sp. and Pneumococcus. CONCLUSIONS Suppurative corneal ulcer is an important cause of preventable blindness. Smear and culture is an essential tool in the diagnosis of these infections. Region based information about the causative organisms and risk factors helps in empirical management, and to formulate guidelines for prevention of suppurative keratitis in the population at risk.
Clinical Ophthalmology, 2019
BackgroundThe most common cause of ocular infections worldwide is bacteria; therefore, bacterial keratitis requires rapid and proper intervention because it is a major cause of loss of vision and ocular morbidity. Resistance studies have found increases in the resistance to ciprofloxacin, cefazolin, and gentamicin in bacterial keratitis cases that are caused by gram-positive organisms.AimTo identify the common predisposing factors, causative organisms, and antibiotic profile of bacterial keratitis (BK) in a tertiary care hospital in Riyadh, Saudi Arabia.MethodThis is a retrospective study of the microbiological record of all patients diagnosed with BK at KAUH. From the first of May 2015 until the first of January 2018. Demographic data, diabetes mellitus, contact lens use, history of eye trauma, ocular surface disorders, recent ocular surgeries, current and recent medications, initial and final visual acuity, and location and size of the infiltrate were all used in the study. VA was converted to the logarithm of the minimum angle of resolution (LogMAR) for statistical analysis.Results177 cases positive for BK were included. 100 (56.5%) were males, and 77 (43.5%) were females. The mean age was 43.15. Trauma was the most common predisposing factor, which was observed in 68 (38.4%) cases, followed by Ocular surface disease [52 (29.4%)]. Staphylococcus epidermidis was the most commonly isolated organism [61 (34.5%)], followed by Streptococcus pneumoniae [23 (13%)], and Staphylococcus aureus [18 (10.2%)]. All gram-positive cases were Vancomycin sensitive. Staphylococcus epidermidis showed only 4 resistant cases to chloramphenicol (7.27%), and resistance to penicillin and ampicillin was found in 55 (90%) and 53 (89.83%) cases, respectively. All Streptococcus pneumoniae cases were resistant to gentamicin (100%). Staphylococcus aureus showed high sensitivity for erythromycin [18 (100%)].ConclusionThe most common cause of bacterial keratitis was Staphylococcus epidermidis (N=61), followed by Streptococcus pneumoniae (N=23). Trauma was the most common predisposing factor (38.4%), while contact lens use was only identified in 14 cases (7.9%). All organisms tested were sensitive to vancomycin, and there was high resistance toward penicillin (90%).
Epidemiology of Bacterial Keratitis in Lumbini Eye Institute
Journal of Chitwan Medical College
Background: Bacterial keratitis is a common sight threatening condition. Untreated, it often leads to progressive tissue destruction with corneal perforation or extension of infection to adjacent tissue. The aim of the study was to study the epidemiological characteristics of bacterial keratitis seen at Lumbini eye institute in western part of Nepal. Methods: A retrospective study was done from 1st November 2017 to 30th October 2018 in which records of all culture-positive bacterial keratitis over a 1 year period. Data regarding age of patient, occupation, type of injury, coexisting ocular disease was recorded. Clinical evaluation corneal scrapings were collected and subjected to culture and microscopy using standard protocols in all patients. Results: Out of 800 corneal ulcer cases, 305(38.12%) were found to be of bacterial aetiology. A total of 100(32.78%) bacterial pathogens were isolated of which predominant bacterial species Staphylococcus epidermidis 56(56%) followed by ...
EPIDEMIOLOGICAL AND MICROBIOLOGICAL PROFILE OF PATIENT'S HAVING MICROBIAL KERATITIS
National Journal of Community Medicine, 2014
Background: Microbial keratitis is common potentially sight threatening ocular infection that may be caused by bacteria, fungi or virus. Epidemiological and microbiological profile of corneal ulceration have been found vary with patient population, health of cornea, geographical location and climate tends to vary over times. Methods: The present cross-sectional study was conducted 3 on patients having microbial keratitis. Detailed history taking include duration of symptoms, predisposing factors, history of trauma, traumatic agents, associated ocular conditions, other systemic disease, treatment received prior to presentation, visual acuity at the time of presentation and all clinical findings were collected. Detailed ocular examination, using standard technique, corneal scraping were also taken under aseptic conditions from each ulcer. Results: In our study, 51 cases belonged to low socio-economic group of which 21 cases (41%) of bacterial keratitis, 15 cases (29%) of fungal keratitis , 11 cases (21%) of viral keratitis and 4 cases (8%) of Mixed (bacterial + fungal ) keratitis. A total 15 bacterial pathogens were isolated from the 64 eyes which yielded only bacterial growth in culture. Out of which 4(16%) were staphylococcus aureus, 4(16%) pseudomonas,3(12%) were streptococcus,2(8%) were staphylococcus epidermis. A total of 17 viral keratitis 9(53%) were recurrent cases. Conclusion: Trauma is most common predisposing factor responsible for microbial keratitis. Direct microscopic examination of corneal scraping is key tool for rapid diagnosing and institution of antimicrobial therapy.