A clinical microbiological study of corneal ulcer patients at western Gujarat, India.
AbstractCorneal ulcer is a major cause of blindness throughout the world. When the cornea is injured by foreign particles, there are chances of infection by the organism and development of ulcer. Bacterial infection in the cornea is invariably an alteration of the defense mechanism of the outer eye. It is essential to determine the local etiology within a given region when planning a corneal ulcer management strategy. Laboratory evaluation is necessary to establish the diagnosis and to guide the antibiotic therapy. One hundred corneal ulcer patients were studied by collecting their corneal scraping samples and processing at Clinical Microbiology department of Shree Meghaji Petharaj Shah Medical College, Jamnagar, Gujarat, India during a period of 17 months. All clinical microbiology laboratory procedures followed standard protocols described in the literature. 40 (40%) patients from the age group of 20-70 years had been confirmed as - any organism culture positive - within the corneal ulcer patient population. Fungi were isolated from 26 (26%) corneal ulcer patients. The bacterial etiology was confirmed in 14 (14%) corneal ulcer patients. The major risk factors for mycotic keratitis were vegetative injury (16, (62%)), followed by conjunctivitis (4, (15%)), and blunt trauma (3, (11%)). Pseudomonas aeruginosa was the most commonly isolated bacterium (6, (43%)), followed by Proteus spp. (4, (29%)). Corneal Infections due to bacteria and filamentous fungi are a frequent cause of corneal damage. Microbiological investigation is an essential tool in the diagnosis of these infections. The frequency of fungal keratitis has risen over the past 20 to 30 years. Prognosis of bacterial corneal infection has improved since the introduction of specific antibacterial therapy.
Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: A global perspective. Bull World Health Organ 2001;79(3):214-21.
Murlikrishnan R, Praveen Krishna R, Thulasiraj RD, Damodar Bachani, Sanjeev Gupta, GVS Murthy.Blindness estimations, projections and service delievery. NCMH Background Papers-Burden of Disease in India. Available at http://whoindia.org/linkfiles/commission_on_macroecono mic_and_Health_Bg_P2_Blindness_estimations_Projectio ns_and_service_delievery.pdf.
Whitcher JP. Corneal ulceration. Int Ophthalmol Clin 1990;30(1):30–2.
McLeod SD. Bacterial Keratitis. In: Myron Yanoff, Jay S Duker, editors. Ophthalmology. 3rd ed. Mosby; 2008. 262-70.
Leck AK, Thomas PA, Hagan M, Kaliamurthy J, Ackuaku E, John M, Newman MJ, Codjoe FS, Opintan JA, Kalavathy CM, Essuman V,Jesudasan CA, Johnson GJ. Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis. Br J Opthalmol 2002;86(11):1211–5.
Jones DB. Diagnosis and management of fungal keratitis. In: Duane CT, ed. Duane's Clinical Ophthalmology. Vol 4. Philadelphia, Pa: Lippincott, 1998; CD-ROM edition.
Mahajan V M. Acute bacterial infections of the eye. Br J Ophthalmol 1983;67(3):191–4.
Khanna B, Deb M, Panda A, Sethi Harindersingh. Laboratory diagnosis in ulcerative keratitis. Opthalmic Res 2005;37(3):123-7.
Srinivasan M, Gonzales C A, George C, Cevallos, Cevallos V, Mascarenhas J M, Asokan B. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India. Br J Opthalmol 1997;81(11):965–71.
Soja MR, Manaviat M. Epiodemiology and outcome of corneal ulcer in Yazd Shahid Sadoughi Hospital. Acta Medica Iranica 2004; 42(2): 136-41.
Poria VC, Bharad VR, Dongre DS, Kulkarni MV. Study of mycotic keratitis. Indian J Ophthalmol 1985;33(4):229-31.
Basak S K, Basak S, Mohanta A, Bhowmick A. Epidemiological and microbiological diagnosis of suppurutive keratitis in Gangetic West Bengal, Eastern India. Indian J Opthalmol 2005;53(1):17-22.