Microbiological Profile in Patients Having Keratitis in a Tertiary Care Hospital in India

Pramanick, Pritha; Banerjee, Madhumita; Ghosh, Sougata; Mitra, Anita Nandi; Chakraborty, Moumita; Sengupta, Mallika

doi:10.7759/cureus.31653

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…Infectious keratitis ranks fifth among the leading causes of severe visual impairment globally[ 3 ]. Microbial keratitis can be bacterial, fungal, or viral/protozoal[ 4 , 5 ]. Viruses are implicated in up to 4/5 th of all conjunctivitis in humans[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Herpes simplex keratitis: A brief clinical overview

Musa,

Enaholo,

Aluyi-Osa

et al. 2024

World J Virol

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The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.

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Section: Introductionmentioning

confidence: 99%

Herpes simplex keratitis: A brief clinical overview

Musa,

Enaholo,

Aluyi-Osa

et al. 2024

World J Virol

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“…The prevalence is higher in developing countries, particularly in regions with poor environmental and personal hygiene, low education levels, and limited access to sanitation and healthcare facilities [6,7]. Risk factors for infectious keratitis include contact lens wear, ocular trauma, ocular surface diseases (such as dry eye), facial nerve palsy, diseases of lacrimal apparatus (such as chronic dacryocystitis), post-corneal surgery (refractive procedures, penetrating or lamellar keratoplasty), corneal leukoma (traumatic or infectious), herpes simplex infections/scarring, and immunosuppressive conditions (diabetes, HIV infection, steroid treatment) [8][9][10]. Understanding the causes of infectious keratitis is necessary to improve prevention, diagnosis, and treatment strategies, and to allocate resources effectively.…”

Section: Introductionmentioning

confidence: 99%

Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania

Bălășoiu,

Zlatian

et al. 2024

Microorganisms

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Infectious keratitis is a significant global problem that can lead to corneal blindness and visual impairments. This study aimed to investigate the etiology of infectious bacterial and fungal keratitis, identify the causative pathogens and their antimicrobial resistance patterns, and analyze the risk factors associated with the development of infectious keratitis. The study was observational and retrospective, involving 226 eyes from 223 patients presented at the Ophthalmology Clinic of the County Clinical Emergency Hospital of Craiova, Romania. The inclusion criteria included corneal ulceration/abscess/infiltrate present on slit-lamp examination and positive microbiological sampling for bacteria or fungi. The study found that the most common causes of infectious keratitis were coagulase-negative staphylococci (35.40%), Staphylococcus aureus (11.06%), and Pseudomonas aeruginosa (14.16%). The Gram-positive bacteria showed high resistance rates to penicillin, moderate rates to gentamycin and clindamycin, and low resistance to chinolones. The Gram-negative bacteria were highly resistant to ampicillin and amoxicillin–clavulanic acid, while third-generation cephalosporins, quinolones, and carbapenems were effective. Systemic antibiotics, such as vancomycine, piperacillin–tazobactam, amikacin, and ceftazidime, show promise against keratitis with low resistance rates, whereas carbapenems and topical aminoglycosides had higher resistance, leaving moxifloxacin as a potential topical option for Gram-positive bacteria and Pseudomonas aeruginosa, albeit with resistance concerns for Klebsiella spp. Although fungal keratitis was rare, Fusarium spp. and Candida albicans were the leading fungal pathogens, with incidences of 2.65% and 2.21%, respectively. Candida albicans was broadly susceptible to most antifungals, while Fusarium solani, Curvularia lunata, and Alternaria alternata exhibited resistance to many antifungals. Amphotericin B and caspofungin can be used as systemic antifungals in fungal keratitis. The study also identified risk factors for keratitis such as ocular trauma (65.92%, OR: 2.5), contact lens wear (11.94%, OR: 1.8), and corneal scarring/leukoma (10.17%, OR: 1.6). Keratitis was more frequent in individuals over 60 years old. The findings of this study have implications for the development of effective diagnostic, therapeutic, and preventive strategies for infectious keratitis.

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“…1 As per reports of the World Health Organization (WHO), major causes of vision loss and blindness in the world today is cataract followed by corneal diseases. [2][3][4][5] According to The National Blindness and Visual Impairment Survey (2015-2019), corneal related diseases are still among the major causes of blindness in India. 6 The patient demographic, corneal health, geographic location, and climate have all been found to affect the aetiology and epidemiological patterns of corneal ulcers, which also tend to change over time.…”

Section: Introductionmentioning

confidence: 99%

Microbiological Profile of Infectious Keratitis at a Tertiary Care Hospital

Chauhan¹,

Kaur²,

Himanshu³

et al. 2023

J. Pure Appl. Microbiol.

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In developing countries, infectious keratitis being the probable cause of preventable blindness, also have a varied epidemiological profile. This study was conducted to know the microbiological profile, risk factors, epidemiology and antimicrobial susceptibility pattern of bacteria isolated from patients with a corneal ulcers. A total of 193 patients who were clinically diagnosed with cases of infective keratitis in the Department of Ophthalmology were included in the study. The sample collected by an ophthalmologist was received in the Microbiology department. All the demographic details and relevant clinical data were noted. The bacterial identification and antimicrobial susceptibility were done using automated methods while the fungal identification was done using the conventional method (Vitek2 Compact system, BioMerieux). Out of 193 patients, 69% were male and 31% % were females. The Majority of cases were from the age group 41- 50 years. Of 193 cases, 83 (43%) showed microbial etiology in culture. Of 83 culture positive cases, 55 (66.3%) were fungal and 28 (33.7%) were bacterial. The most common isolated fungus was Fusarium species detected in 24 (28.9%) cases followed by Aspergillus species in 14 (16.8%) cases. Gram positive bacteria were predominantly isolated from cases of infective keratitis. Staphylococcus aureus was the most common isolated bacteria in 12 (14.4%) out of 83 positive cases followed by Coagulase negative Staphylococcus. Pseudomonas aeruginosa was the most common Gram negative bacteria isolated from the cases. Among the topical antimicrobials, both Gram positive bacteria as well as Gram negative bacteria showed maximum sensitivity to levofloxacin. Proper knowledge of the clinical presentation and etiological agents aided with microbiological examination is necessary in order to effectively treat corneal ulcers and prevent further complications that can lead to blindness.

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Microbiological Profile in Patients Having Keratitis in a Tertiary Care Hospital in India

Cited by 5 publications

References 30 publications

Herpes simplex keratitis: A brief clinical overview

Herpes simplex keratitis: A brief clinical overview

Bacterial and Fungal Keratitis in a Tertiary Care Hospital from Romania

Microbiological Profile of Infectious Keratitis at a Tertiary Care Hospital

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