Types of organisms and in-vitro susceptibility of bacterial isolates from patients with microbial keratitis: A trend analysis of 8 years

Abstract

Purpose:To report the distribution and trends of types of organisms and antibiotic susceptibility of the bacterial isolates obtained from patients with microbial keratitis.Methods:Microbiology records of culture-positive microbial keratitis that underwent a diagnostic corneal scraping and cultures were reviewed. Fungal, bacterial, and parasitic culture results and antibiotic susceptibility profile of bacteria were analyzed and comparisons were made between two halves of the study period (2007–2010 vs. 2011–2014).Results:A total of 3981 corneal scrapings were processed during the 8-year study period. Pathogen was recovered in culture in 1914 (48.1%) samples. Fungi, bacteria, and parasites constituted 38.7%, 60%, and 1.3% of the total isolates, respectively. The common fungal isolates were Aspergillus spp. (224/868, 25.8%) and Fusarium spp. (200/868, 23.0%), while common Gram-positive bacteria were Streptococcus pneumoniae (217/1125, 19.3%) and Staphylococcus aureus (185/1125, 16.4%), and common Gram-negative bacteria was Pseudomonas spp. (99/219, 45.2%). There was no significant difference in proportion of bacterial (P = 0.225) and fungal (P = 0.421) keratitis between the first half and second half of the study period. There was a significant increase in proportion of Gram-positive isolates (P = 0.015) [353/758 (46.6%) vs. 772/1482 (52.1%)] and decrease in proportion of Gram-negative organisms (P = 0.044) [88/758 (11.6%) vs. 131/1482 (8.8%)] in the recent years. In-vitro antibiotic susceptibility testing showed decrease in susceptibility to moxifloxacin for Pseudomonas spp. (P = 0.016) in recent years.Conclusion:Prevalence of fungal and bacterial keratitis has remained unchanged over the years. This study shows a significant increase in Gram-positive bacterial infection and decrease in Gram-negative bacterial infection of the cornea in the recent years.

Delhi infectious keratitis study: Update on clinico-Microbiological profile and outcomes of infectious keratitis

“…have been the most commonly isolated organisms. 24 In our study, both showed good sensitivity to vancomycin (>90%) and variable sensitivity to various fluoroquinolones. A recent update from South India showed similar sensitivity toward vancomycin; however, they had good sensitivity toward fluoroquinolones as well, 11 which was not seen in our patients.…”

“…It was most sensitive to imipenem. Other studies have showed better sensitivity patterns, 11 but at the same time, one should not miss the worrying trends of multidrug-resistant Pseudomonas spp. from around the world, 25 26 a reflection of which we are also beginning to see in our clinics.…”

“…Significant work has been done in South India with regard to IK, 2 6 7 10 11 and some literature is also available from central 12 and eastern 13 India. However, to the best of our knowledge (PubMed search of microbial keratitis, infectious, India, and north), there is no major epidemiological study describing the correlation between microbiological profile, risk factors, antibiotic susceptibility, and clinical outcome from North India in the last decade.…”

Characterization of Ocular Clinical Isolates of Pseudomonas aeruginosa from Non-Contact Lens Related Keratitis Patients from South India

“…They found that the antibiotic resistance rates in ocular isolates have been stable [24] however, a recent report from Das et al found a significant decrease in susceptibility in Pseudomonas spp. isolated from keratitis patients to a fourth generation fluoroquinolone, moxifloxacin [25], suggesting a rise in antibiotic resistance in Pseudomonas spp. Various studies have investigated the virulence factors in clinical isolates from diseases such as cystic fibrosis, respiratory infections, septicemia, and keratitis [26][27][28][29][30].…”

Bacterial isolates in microbial keratitis: Three-year trend analysis from North India

“…We read with great interest the article titled “Types of organisms and in-vitro susceptibility of bacterial isolates from patients with microbial keratitis: A trend analysis of 8 years” by Das et al . [1] As a tertiary eye care provider and one of the biggest cornea departments in north India, we congratulate the authors for their brilliant work, would like to use this opportunity to reflect upon, and compare the microbial profile and antibiotic sensitivity seen in our practice. We agree with the authors that local epidemiological studies are required to provide evidence-based management of microbial keratitis,[1] and hence, wanted to add our data from north India to their study, to give a pan India perspective to our readers.…”