Systemic Evaluation on Antifungal Susceptibility of Keratitis Associated Fungal Pathogens in Eastern India

Abstract

Assessment of the keratitis associated fungal pathogens and realizes their antifungal sensitivity pattern in Eastern India for better guidance and appropriate choice of antifungal drugs was made. A retrospective, non-comparative study was conducted on 248 fungal keratitis patients between August’2009-July’2012. Corneal scraping was performed and evaluated antifungal susceptibility in all cases. Culture positive fungal keratitis were found in 77.82% cases in which the most predominating pathogen was Aspergillus sp of 46.63% including Aspergillus fumigatus in 41 cases (45.55%) and Aspergillus flavus in 25 cases (27.77%). Aspergillus sp was mostly sensitive to voriconazole next to natamycin and amphotericin B. The second most common pathogen was Candida albicans in 36 cases (18.94%). Candida sp was mostly sensitive to amphotericin B followed by natamycin. Candida sp was relatively insensitive to fluconazole and voriconazole. The third common fungal pathogen was Fusarium sp in 30 cases, among them F. solani in 27 cases (90%). Fusarium sp was mostly sensitive to voriconazole next to natamycin. Aspergillus, Candida and Fusarium were insensitive to fluconazole, micronazole and itraconazole. Aspergillus sp is the most common pathogen of fungal keratitis followed by Candida and Fusarium sp. Voriconazole is still the first choice in the treatment of mould keratitis. Early diagnosis and treatments are vital for better management of fungal keratitis.