Publication:

A retrospective study to analyse epidemiological profile of community acquired infectious keratitis in a tertiary care hospital located in Northern Mumbai

Background Epidemiology of infectious keratitis varies with geographical location. The aim of the study was to review the etiology of infectious keratitis in community that will help in management strategy.

Methods A retrospective study was conducted at tertiary care hospital from November 2017 to December 2020. Corneal scrapings and corneal button were processed as per microbiological standards. Bacterial identification and antimicrobial sensitivity testing was done by automated Vitek-2 compact system. Significant fungal growth was confirmed by its colony morphology, pigment production and lacto phenol cotton blue (LPCB) mount examination.

Results Of total 130 patients, culture positivity was 63 (48%), of these 59 (53%) were from corneal scrapping and 4 (21%) from corneal button. The most common bacterial isolates were Streptococcus pneumoniae 12 (38%), followed by Pseudomonas aeruginosa 6 (19%) and Staphylococcus aureus 4 (12%). The most common fungi isolated was Fusarium spp 14 (47%) followed by Aspergillus spp 9 (30%). One specimen showed Acanthamoba spp in wet mount preparation. Major associated factors were injury with vegetative matter 30 (48%) followed by contact lens use 12 (19%) and diabetes mellitus 11 (17%). Antibiotic susceptibility tests showed that all gram-positive cocci were susceptible to vancomycin (100%) and fluoroquinolones (100%) followed by third generation cephalosporins (80%). Whereas all gram-negative bacilli were susceptible to aminoglycosides (100%) followed by fluoroquinolones (90%).

Conclusions Epidemiology of infectious keratitis vary with geographical location. Understanding local microbiological profile assist in empirical therapy when diagnostic facilities are not readily available.