To Study the Spectrum of Bacterial Keratitis in Western India

Main Article Content

B. S. Joshi
V. H. Karambelkar
Aikya Gadhiya

Abstract

Aim: To study the spectrum of bacterial keratitis in western India.


Material and methods: The study, which received ethical board approval from the authors' institution, involved a retrospective analysis of all subjects who presented to ophthalmic microbiology having a diagnosed infectious corneal ulceration. Following topical anaesthesia, an ophthalmologist scraped the base as well as edges of the ulcerated portion of the cornea with a sterile Kimura platinum spatula or a sterile Bard-Parker knife while using a slit lamp to magnify the area. Standard microbiological examinations were now possible.


Results: From the 250 corneal lesions that were scraped, 100 were found to have bacteria as the single isolating organism. Fifty patients showed considerable development of several bacterial species or growth of multiple bacterial species and fungi ("mixed growth") in the scraped ulcer. Eighty (80%) of the bacterial culture isolates were Gram-positive, whereas just twenty (20%) were Gram-negative. Staphylococcus spp. were the most frequently identified bacterial pathogens (61%), followed by Streptococcus spp. (13%), Pseudomonas aeruginosa (10%), Bacillus spp. (5%), Acinetobacter spp. (3%) and Aeromonas spp. (2%). The least common bacterial isolates were from species including Enterobacter, Klebsiella, Serratia marcescens, and Flavobacterium.


Conclusion: In this scenario, Staphylococcus spp. were the most often identified bacterial pathogens from keratitis patients. Both gatifloxacin and moxifloxacin showed excellent susceptibility against a wide range of Gram-positive and Gram-negative bacteria.

Article Details

How to Cite
Joshi, B. S. ., Karambelkar, V. H. ., & Gadhiya, A. . (2023). To Study the Spectrum of Bacterial Keratitis in Western India. Journal of Coastal Life Medicine, 11(1), 457–467. Retrieved from https://www.jclmm.com/index.php/journal/article/view/365
Section
Articles

References

Leck A.K., Thomas P.A., Hagan M. et al., “Aetiology of suppura- tive corneal ulcers in Ghana and South India, and epidemiology of fungal keratitis,” The British Journal of Ophthalmology, vol. 86, no. 11, pp. 1211–1215, 2002.

Bharathi M.J., Ramakrishnan R., Vasu S., Meenakshi R., and Palaniappan R., “In-vitro efficacy of antibacterials against bacterial isolates from corneal ulcers,” Indian Journal of Ophthalmology, vol. 50, no. 2, pp. 109–114, 2002.

Schaefer F., Bruttin O., Zografos L., and Guex-Crosier Y., “Bacterial keratitis: a prospective clinical and microbiological study,” The British Journal of Ophthalmology, vol. 85, no. 7, pp. 842–847, 2001.

Pinna A., Zanetti S., Sotgiu M., Sechi L.A., Fadda G., and Carta F., “Identification and antibiotic susceptibility of coagulase negative staphylococci isolated in corneal/external infections,” The British Journal of Ophthalmology, vol. 83, no. 7, pp. 771–773, 1999.

Manikandan P., Bhaskar M., Revathy R., John R.K., Narendran, and Narendran V., “Speciation of coagulase negative Staphylococcus causing bacterial keratitis,” Indian Journal of Oph- thalmology, vol. 53, no. 1, pp. 59–60, 2005.

Ly C.N., Pham J.N., Badenoch P.R. et al., “Bacteria commonly isolated from keratitis specimens retain antibiotic susceptibility to fluoroquinolones and gentamicin plus cephalothin,” Clinical and Experimental Ophthalmology, vol. 34, no. 1, pp. 44–50, 2006.

John J.F. and Harvin A.M., “History and evolution of antibiotic resistance in coagulase-negative staphylococci: susceptibility profiles of new anti-staphylococcal agents,” Therapeutics and Clinical Risk Management, vol. 3, no. 6, pp. 1143–1152, 2007.

Schein O.D., Buehler P.O., Stamler J.F., Verdier D.D., and Katz J., “The impact of overnight wear on the risk of contact lens- associated ulcerative keratitis,” Archives of Ophthalmology, vol. 112, no. 2, pp. 186–190, 1994.

Goldstein M.H., Kowalski R.P., and Gordon Y.J., “Emerging fluoroquinolone resistance in bacterial keratitis: a 5-year review,” Ophthalmology, vol. 106, no. 7, pp. 1313–1318, 1999.

Smitha S., Lalitha P., Prajna V.N. et al., “Susceptibility trends of Pseudomonas species from corneal ulcers,” Indian Journal of Medical Microbiology, vol. 23, no. 3, pp. 168–171, 2005.

Wilhelmus K.R., “Bacterial keratitis,” in Ocular Infection and Immunity, J. S. Pepose, G. N. Holland, and K. R. Wilhelmus, Eds., pp. 970–1031, Mosby, St. Louis, Mo, USA, 1996.

Barrow G.I. and R. Feltham R.K.A., Cowan and Steel’s Manual for the Identification of Medical Bacteria, Cambridge University Press, Cambridge, UK, 3rd edition, 1993.

Pachigolla G., Blomquist P., and Cavanagh H.D., “Microbial keratitis pathogens and antibiotic susceptibilities: a 5-year review of cases at an urban county hospital in North Texas,” Eye and Contact Lens, vol. 33, no. 1, pp. 45–49, 2007.

Shoja M.R. and Manaviat M., “Epidemiology and outcome of corneal ulcers in Yazd Shahid Sadoughi hospital,” Acta Medica Iranica, vol. 42, no. 2, pp. 136–141, 2004.

Muhsin Warid F.A., Mansouri F.A., and Qahtani O.A., “Bacterial keratitis predisposing factors, clinical and microbiological review of 70 cases,” The Middle East Journal of Emergency Medicine, vol. 5, no. 1, 2005.

Bataineh H., Hammory Q., and Khatatba A., “Bacterial keratitis: risk factors and causative agents,” Sudan Journal of Medical Science, vol. 3, no. 1, 2008.

Tabbara K.F., El-Sheikh H.F., and Aabed B., “Extended wear contact lens related bacterial keratitis,” The British Journal of Ophthalmology, vol. 84, no. 3, pp. 327–328, 2000.

Bourcier T., Thomas F., Borderie V., Chaumeil C., and Laroche L., “Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases,” The British Journal of Ophthalmology, vol. 87, no. 7, pp. 834–838, 2003.

Butler T.K., Spencer N.A., Chan C.C.K., Gilhotra J.S., and McClellan K., “Infective keratitis in older patients: a 4 year review, 1998–2002,” The British Journal of Ophthalmology, vol. 89, no. 5, pp. 591–596, 2005

Green M.D., Apel A.J.G., Naduvilath T., and Stapleton F.J., “Clinical outcomes of keratitis,” Clinical and Experimental Ophthalmology, vol. 35, no. 5, pp. 421–426, 2007.

Asbell P. and Stenson S., “Ulcerative keratitis. Survey of 30 years’ laboratory experience,” Archives of Ophthalmology, vol. 100, no. 1, pp. 77–80, 1982.

Groden L.R., Rodnite J., Brinser J.H., and Genvert G.I., “Acridine orange and Gram stains in infectious keratitis,” Cornea, vol. 9, no. 2, pp. 122–124, 1990.

Diamond J., Leeming J., Coombs G. et al., “Corneal biopsy with tissue micro-homogenisation for isolation of organisms in bacterial keratitis,” Eye, vol. 13, no. 4, pp. 545–549, 1999.

Synder R.W. and Hyndiuk A., “Mechanisms of bacteri- alinvasion of the cornea,” in Duane’s Foundations of Clinical Ophthalmology, W. Tasman and E. A. Jaeger, Eds., pp. 11–44, J B Lippincott, Philadelphia, Pa, USA, 1990.

Reichert R. and Stern G., “Quantitative adherence of bacteria to human corneal epithelial cells,” Archives of Ophthalmology, vol. 102, no. 9, pp. 1394–1395, 1984.

Panjwani N., Clark B., Cohen M., Barza M., and Baum J., “Differential binding of P. aeruginosa and S. aureus to corneal epithelium in culture,” Investigative Ophthalmology and Visual Science, vol. 31, no. 4, pp. 696–701, 1990.

Sharma S., Kunimoto D.Y., Garg P., and Rao G.N., “Trends in antibiotic resistance of corneal pathogens—part I. An analysis of commonly used ocular antibiotics,” Indian Journal of Oph- thalmology, vol. 47, no. 2, pp. 95–100, 1999.

Vajpayee R.B., Dada T., Saxena R. et al., “Study of the first contact management profile of cases of infectious keratitis: a hospital-based study,” Cornea, vol. 19, no. 1, pp. 52–56, 2000.

Singh G., Palanisamy M., Madhavan B. et al., “Multivariate analysis of childhood microbial keratitis in South India,” Annals of the Academy of Medicine, vol. 35, no. 3, pp. 185–189, 2006.

Miedziak A.I., Miller M.R., Rapuano C.J., Laibson P.R., and

Cohen E.J., “Risk factors in microbial keratitis leading to pene- trating keratoplasty,” Ophthalmology, vol. 106, no. 6, pp. 1166– 1170, 1999.

Mezer E., Gelfand Y.A., Lotan R., Tamir A., and Miller B., “Bacteriological profile of ophthalmic infections in an Israeli hospital,” European Journal of Ophthalmology, vol. 9, no. 2, pp. 120–124, 1999.

Cheung J. and Slomovic A.R., “Microbial etiology and predis- posing factors among patients hospitalized for corneal ulceration,” Canadian Journal of Ophthalmology, vol. 30, no. 5, pp. 251– 255, 1995.

Wong T., Ormonde S., Gamble G., and McGhee C.N.J., “Severe infective keratitis leading to hospital admission in New Zealand,” The British Journal of Ophthalmology, vol. 87, no. 9, pp. 1103–1108, 2003.

Srinivasan M., Gonzales C.A., George C. et al., “Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, South India,” The British Journal of Ophthalmology, vol. 81, no. 11, pp. 965–971, 1997.

Williams G., Billson F., Husain R., Howlader S.A., Islam N., and McClellan K., “Microbiological diagnosis of suppurative keratitis in Bangladesh,” The British Journal of Ophthalmology, vol. 71, no. 4, pp. 315–321, 1987.

Al-Hazzaa S.A.F. and Tabbara K.F., “Bacterial keratitis after penetrating keratoplasty,” Ophthalmology, vol. 95, no. 11, pp. 1504–1508, 1988

Aasuri M.K., Reddy M.K., Sharma S., and Rao G.N., “Co-occ- urrence of pneumococcal keratitis and dacryocystitis,” Cornea, vol. 18, no. 3, pp. 273–276, 1999.

Liesegang T. J. and Forster R.K., “Spectrum of microbial keratitis in South Florida,” American Journal of Ophthalmology, vol. 90, no. 1, pp. 38–47, 1980.

Houang E., Lam D, Fan, and Seal, “Microbial keratitis in Hong Kong: relationship to climate, environment and contact- lens disinfection,” Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 95, no. 4, pp. 361–367, 2001.

Hooi S.H. and Hooi S.T., “Culture-proven bacterial keratitis in a Malaysian General hospital,” Medical Journal of Malaysia, vol. 60, no. 5, pp. 614–623, 2005.

Sun X., Deng S., Li R. et al., “Distribution and shifting trends of bacterial keratitis in North China (1989–98),” The British Journal of Ophthalmology, vol. 88, no. 2, pp. 165–166, 2004.

Asbell P.A., Colby K.A., Deng S. et al., “Ocular TRUST: nation- wide antimicrobial ausceptibility patterns in ocular isolates,” American Journal of Ophthalmology, vol. 145, no. 6, pp. 951–958, 2008.

Høvding G., “Acute bacterial conjunctivitis,” Acta Ophthalmo- logica, vol. 86, no. 1, pp. 5–17, 2008.

Sheikh A. and Hurwitz B., “Antibiotics versus placebo for acute bacterial conjunctivitis,” Cochrane Database of Systematic Reviews, no. 2, Article ID CD001211, 2006.

Parmar P., Salman A., Kalavathy C.M., Kaliamurthy J., Thomas P.A., and Jesudasan C.A.N., “Microbial keratitis at extremes of age,” Cornea, vol. 25, no. 2, pp. 153–158, 2006.

Kaliamurthy J., Nelson Jesudasan C.A., Geraldine P., Parmar P., Kalavathy C.M., and P. A. Thomas P.A., “Comparison of in vitro susceptibilities of ocular bacterial isolates to gatifloxacin and other topical antibiotics,” Ophthalmic Research, vol. 37, no. 3, pp. 117–122, 2005.

Moss J.M., Sanislo S.R., and Ta C.N., “Antibiotic susceptibility patterns of ocular bacterial flora in patients undergoing intrav- itreal injections,” Ophthalmology, vol. 117, no. 11, pp. 2141–2145, 2010.

Jhanji V., Sharma N., Satpathy G., and Titiyal J., “Fourth- generation fluoroquinolone-resistant bacterial keratitis,” Journal of Cataract and Refractive Surgery, vol. 33, no. 8, pp. 1488– 1489, 2007.

Blondeau J.M., Hansen G., Metzler K., and Hedlin P., “The role of PK/PD parameters to avoid selection and increase of resis- tance: mutant prevention concentration,” Journal of Chemother- apy, vol. 16, no. 3, pp. 1–19, 2004.

Cambau E., Matrat S., Pan X. et al., “Target specificity of the new fluoroquinolone besifloxacin in Streptococcus pneumoniae, Staphylococcus aureus and Escherichia coli,” Journal of Antimi- crobial Chemotherapy, vol. 63, no. 3, pp. 443–450, 2009