Abstract
Purpose:To identify the prevalence and microbial profile of infectious keratitis in a tertiary eye care hospital, and to test for the in vitro antimicrobial resistance of the bacterial isolates.Methods:A total of 312 patients presenting to a tertiary eye care hospital with infected corneal ulcer were enrolled in this study. Their socio-demographic data and risk factors were recorded. Corneal scrapings collected from the edge of the ulcer were processed for direct gram stain and KOH mount. Culture was recovered on blood agar, chocolate agar, MacConkey agar and Sabouraud's dextrose (SDA) agar in multiple C shaped streaks. After overnight incubation, bacterial culture was followed by standard biochemical tests and antimicrobial sensitivity according to the clinical and laboratory standards institute (CLSI) guidelines. Inoculated SDA was inspected daily for up to 10 days and the growth was identified by its colony morphology, pigment production and lacto-phenol cotton blue mount examination.Results:Of 312 patients, a microbial etiology was established in 117 cases (37.5%). Of these, 72 (61.5%) were male. The age range of 41-60 years was the most affected group. Of 117 positive cases, 52 (44.5%) were bacterial, 58 (49.5%) were fungal and 7 (6%) patients showed mixed bacterial and fungal infection. The most common isolated fungus was Fusarium which was detected in 36 (31%) cases, followed by Aspergillus spp in 13 (11%) subjects. Staphylococcus aureus was the most common isolated bacteria. All Gram positive cocci were susceptible to vancomycin followed by gatifloxacin, whereas all Gram negative bacilli were susceptible to gatifloxacin.Conclusion:Routine microbiological examination of patients with corneal ulcer is necessary in order to analyze and compare the changing trends of the etiology and their susceptibility patterns.
Highlights
Infectious keratitis is a leading cause of corneal blindness in developing countries.[1]
Fungi are the most common etiological agents which account for 30–40% whereas bacteria account for 13–48% of all cases of suppurative keratitis; this varies by geographical area.[3]
Bacterial culture was confirmed by growth on blood agar, chocolate agar and MacConkey agar followed by standard biochemical tests according to the clinical and laboratory standards institute (CLSI) guidelines
Summary
Infectious keratitis is a leading cause of corneal blindness in developing countries.[1] Corneal ulceration results in Received: 30‐03‐2016. 1.5–2 million new cases of corneal blindness annually, posing a major public health problem according to the World Health Organization (WHO) reports.[2] Fungi are the most common etiological agents which account for 30–40% whereas bacteria account for 13–48% of all cases of suppurative keratitis; this varies by geographical area.[3] These pathogens lead to corneal damage directly or by release of toxins and enzymes or by activating the host immune system.[4] An intact corneal epithelium acts as a barrier for the majority of microorganisms.
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