Clinical and Microbiological Profile of Bacterial and Fungal Suspected Corneal Ulcer at University of Gondar Tertiary Eye Care and Training Centre, Northwest Ethiopia

Tarekegn Wuletaw,Mekuanint Geta,Baye Gelaw,Adane Bitew,Wossen Mulugeta,Mohit Parekh

doi:10.1155/2021/3940151

Tarekegn Wuletaw, Mekuanint Geta + Show 4 more

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https://doi.org/10.1155/2021/3940151

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Abstract

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. Therefore, 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. The 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. The 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. The 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. The commonest fungi and bacteria isolated were Aspergillus species (69%) and S. aureus, respectively. The prevalence of Methicillin-resistant S. aureus (MRSA) was 2 (40%). The identified Pseudomonas species were susceptible to Gentamicin and Ciprofloxacin but resistant to Ceftriaxone. Conclusion. The 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.

Highlights

A corneal ulcer is a major cause of monocular blindness in developing countries, including Ethiopia
Study Area. e thesis was performed at the University of Gondar Tertiary Eye Care and Training Centre, which is situated in the administrative zone in Central Gondar, Amhara National, Regional State, Northwest Ethiopia
A corneal ulcer is a significant cause of corneal blindness worldwide. e clinical profile and spectrum of microorganisms responsible for corneal ulceration are variables depending on the patient population, geographic location, and climatic conditions [8,9,10]

Summary

Introduction

A corneal ulcer is a major cause of monocular blindness in developing countries, including Ethiopia. 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%). Fungi were identified in 53.3% of corneal ulcers followed by 33.3% of bacterial growth. E primary microbial agents for corneal ulcers were fungi, and trauma was the most significant risk factor associated with corneal ulcers. A corneal ulcer is discontinuation of necrosis of the underlying corneal tissue on the normal epithelial surface of the cornea [1] It is a major worldwide cause of corneal blindness that is mostly under-reported but can be responsible every year for 1.5–2.0 million new cases of monocular blindness [2]. Demographic and geographic factors affect the distribution of the causative organisms of infectious corneal ulceration [8,9,10]. ey include pre-existing corneal disease as well as other risk factors such as contactlens wear, surgical or non-surgical trauma, and ocular surface disease, contaminated ocular medications, impaired defense mechanisms, and altered structure of the corneal surface [1, 8]

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