Aims/background-To determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in Madurai, south India, and to identify the specific pathogenic organisms responsible for infection. Methods-All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service at Aravind Eye Hospital, Madurai, from 1 January to 31 March 1994 were evaluated. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. Conclusions-Central corneal ulceration is a common problem in south India and most often occurs after a superficial corneal injury with organic material. Bacterial and fungal infections occur in equal numbers with Streptococcus pneumoniae accounting for the majority of bacterial ulcers and Fusarium spp responsible for most of the fungal infections. These findings have important public health implications for the treatment and prevention of corneal ulceration in the developing world. (Br J Ophthalmol 1997;81:965-971) Central corneal ulceration is a major cause of monocular blindness in developing countries. Surveys in Africa and Asia have confirmed this finding, 1-6 and a recent report on the causes of blindness worldwide consistently lists corneal scarring second only to cataract as the major aetiology of blindness and visual disability in many of the developing nations in Asia, Africa, and the Middle East. Results-In

Aim: To describe the relationship between antibiotic and antibacterial resistance in environmental and clinical bacteria from home environments across geographical locations, relative to the use or nonuse of antibacterial products, with a focus on target organisms recognized as potential human pathogens. Methods and Results: In a randomized study, environmental and clinical samples were collected from the homes of antibacterial product users (n ¼ 30) and nonusers (n ¼ 30) for the isolation of target bacteria for antibiotic and antibacterial testing in three geographical areas (in USA and UK). Isolates were tested for antibiotic susceptibility, with selected antibiotic-resistant and antibiotic-susceptible isolates tested against four common antibacterial agents (triclosan, para-chloro-meta-xylenol, pine oil and quaternary ammonium compound). Prequalified users and nonusers at each location were randomly selected after meeting exclusionary criteria.Of 1238 isolates, more target bacteria were recovered from nonuser than user homes. Of Staphylococcus aureus isolates (n ¼ 33), none showed resistance to oxacillin or vancomycin; for Enterococcus sp. (n ¼ 149), none were resistant to ampicillin or vancomycin; and for Klebsiella pneumoniae (n ¼ 54)and Escherichia coli (n ¼ 24), none were resistant to third generation cephalosporins. Antibiotic resistance to one or more of the standard test panel drugs for Gram-positive and Gram-negative target bacteria was comparable between nonuser and user homes for both environmental and clinical isolates [e.g. resistance of environmental coagulase-negative (CN) Staphylococcus sp. was 73AE8% (124/168) from nonuser homes and 73AE0% (111/152) from user homes, and Enterobacteriaceae other than E. coli, 75AE9% (186/245) from nonuser homes compared with 78AE0% from user homes]. Of 524 Gram-negatives tested against preferred/alternative drugs, 97AE1% (509/524) were susceptible to all antibiotics, across both groups. Isolates of S. aureus, Enterococcus sp. and CN Staphylococcus sp. susceptible to all preferred treatment drugs showed comparable antibacterial minimum inhibitory concentration (MIC) results between nonuser and user home isolates. For Gram-positives resistant to one or more preferred drugs, greatest resistance to antibacterial active ingredients was found in the nonuser group. For Gram-negatives, the antibacterial MIC data were comparable for isolates that were fully susceptible and resistant to one or more preferred/alternative treatment antibiotics.This study was conducted in central North Carolina and northern New Jersey in the USA, and in north-eastern England in the UK. 2003, 95, 664-676 doi:10.1046/j.1365-2672.2003.02022.x Conclusions: The results showed a lack of antibiotic and antibacterial agent cross-resistance in target bacteria from the homes of antibacterial product users and nonusers, as well as increased prevalence of potential pathogens in nonuser homes. Significance and Impact of the Study: It refutes widely publicized, yet unsupported, hypotheses that use o...

No abstract

No abstract