Epidemiological and Microbiological Profile of Infective Keratitis at a Tertiary Care Centre in Central Zone of Kerala, India
Introduction: Infective keratitis is a potentially vision threatening condition caused by various microbial etiology. Due to high virulence and rapid progression of many etiological agents, any corneal inflammation should be considered a potential threat to vision, requiring immediate evaluation...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2017-01-01
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| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.njlm.net/articles/PDF/2192/25182_CE[VSU]_F(GH)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf |
| Summary: | Introduction: Infective keratitis is a potentially vision threatening
condition caused by various microbial etiology. Due to high
virulence and rapid progression of many etiological agents,
any corneal inflammation should be considered a potential
threat to vision, requiring immediate evaluation and treatment.
Evaluation of epidemiological and microbiological profile of
infective keratitis of a region can significantly contribute towards
appropriate management of this ophthalmic emergency.
Aim: To study the bacterial and fungal etiological agents and
the epidemiological factors associated with infective keratitis
in patients attending the Ophthalmology Department of
Government Medical College, Thrissur, Kerala, India.
Settings and Study Design: In this cross-sectional study, a
total of 135 corneal scrapings were evaluated from patients
presenting with corneal ulcers from December 2012 to May
2014.
Materials and Methods: Scrapings were subjected to Gram
staining, KOH wet mount and culture for bacterial and fungal
pathogens. Isolates were identified by conventional methods
and their antibiotic susceptibility pattern was established.
Statistical Analysis: The results were analysed by mean, Chisquare test and Fisher’s exact test.
Results: Corneal trauma was the main risk factor associated
with infective keratitis (59.3%) and vegetative matter was
the most common trauma type observed (36.3%). Culture
was positive in 35.56% of cases, of which 18.52% were
bacterial and 17.04% were fungal. Gram positive cocci were
the predominant isolates (64%). Staphylococcus epidermidis
was the most common bacterial isolate (32%), followed by
Streptococcus pneumoniae and Pseudomonas aeruginosa
(16% each). Fusarium species was the most common fungal
isolate (39.13%), followed by Curvularia species and Aspergillus
species (13.04%). Unidentified dematiaceous fungi accounted
for 17.39%. Sensitivity of Gram stain in bacterial and fungal
detection was 56% and 39%, while specificity was 95% and
96% respectively. Sensitivity and specificity of KOH wet mount
examination in the detection of fungal elements was observed
as 82% and 91% respectively.
Conclusion: Our study observed corneal injury as the main
risk factor associated with infective keratitis. Males were
more affected than females. Staphylococcus epidermidis
and Fusarium species were the commonest bacterial and
fungal isolates respectively. Geographical variation persists in
microbial etiology of infective keratitis |
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| ISSN: | 2277-8551 2455-6882 |