Changing trends in fungal and bacterial profile of infectious keratitis at a tertiary care hospital: A six-year study

Abstract

BackgroundBacteria and fungi are important aetiological agents of infectious keratitis in India. This retrospective study was done to know causative fungal and bacterial species and associated risk factors in patients with suspected fungal or bacterial keratitis. The study included all cases (400) of corneal ulcer investigated and treated at a tertiary care hospital over 6 years. MethodsGram staining and 10% KOH wet mount were performed on corneal scrapings. Further identification of fungal and bacterial agents was done using routine methods. ResultsFungal and bacterial pathogens were identified in 94 (23.50%) and 44 (11.00%) cases, respectively. Keratitis was significantly associated with fungal aetiology. Most frequent agent of fungal keratitis was Fusarium species (26, 27.66%). Fungal keratitis was associated with young and middle-aged agriculturists and labourers, and corneal injury with vegetative matter. Most frequent agent of bacterial keratitis was Staphylococcus aureus (22, 50.00%). Bacterial keratitis was associated with co-existing ocular diseases, diabetes mellitus, previous ocular surgery, contact lenses and metallic foreign bodies in eyes. Fungal keratitis cases had worse overall outcome compared to bacterial keratitis. ConclusionsKnowledge of predisposing factors and microbiological confirmation of keratitis is indispensable to initiate appropriate therapy. We found continuous rise in incidence of Fusarium keratitis, which is disturbing due to multidrug-resistant nature of the fungus. Routine surveillance of fungal and bacterial keratitis is needed to know the existing and emerging pattern of pathogens.