Microbiological profile and antimicrobial sensitivity pattern of culture positive bacterial keratitis: A prospective observational study

A. Satish, M. DeborahPurushottam, A. Acharya
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Abstract

Background: Microbial keratitis is suppurative infection of cornea considered as emergency and potential threat to vision. Prompt diagnosis and treatment of microbial keratitis is required to prevent complication and blindness. So present study has been designed to determine bacteriological profile and sensitivity pattern of culture positive bacterial keratitis, risk factor associated it and treatment outcome.Material and Method: After enrolment of patients a detailed relevant history of patients regarding to mode of injury and predisposing factor were recorded and detailed clinical examination was done. Visual acuity of all patients was tested. Slit lamp biomicroscopy was performed and Corneal ulcer was examined properly. Under local anaesthesia with 4% lignocaine corneal scrap was taken from edge and base of ulcer. Sample was sent for gram stain, 10% KOH wet mount preparation, blood agar and Sabouraud's dextrose agar.Result: In present study out of 600 specimen 460(76.66%) patients were culture positive out of them 47.33% were fungal and remaining were bacterial(29.33%). Regarding bacteriological profile of culture positive corneal ulcer, we have observed that gram positive bacteria were common than gram negative. Among all staphylococcus aureus was common organism 54(30.68%).Discussion and Conclusion: From present study we can conclude that bacterial corneal ulcer is less common than funga ulcer. Regarding bacteriological profile of culture positive corneal ulcer, we have observed that gram positive bacteria were common than gram negative. Among all staphylococcus aureus was common organism followed by pseudomonas. Regarding sensitivity of common organism isolated staphylococcus was 100% sensitive to vancomycin and azithromycin, sensitivity to fluoroquinolones were from 60 % to 80 %. More than 80% pseudomonas was sensitive to fluoroquinolones and aminoglycosides. 77.27% patients were recovered at final follow up.
培养阳性细菌性角膜炎的微生物学特征和抗菌药物敏感性模式:一项前瞻性观察研究
背景:微生物性角膜炎是一种角膜化脓性感染,被认为是一种紧急情况,对视力有潜在威胁。为了防止并发症和致盲,需要及时诊断和治疗微生物角膜炎。因此,本研究旨在确定培养阳性细菌性角膜炎的细菌学特征、敏感性模式、相关危险因素和治疗效果。材料与方法:患者入组后详细记录患者损伤方式及诱发因素的相关病史,并进行详细的临床检查。对所有患者进行视力检查。进行裂隙灯生物显微镜检查,并对角膜溃疡进行检查。在4%利多卡因局部麻醉下,从溃疡边缘和底部取角膜屑。样品送去革兰氏染色、10% KOH湿片制备、血琼脂和沙伯劳德葡萄糖琼脂。结果:本组600例标本中培养阳性460例(76.66%),其中真菌检出47.33%,细菌检出29.33%。关于培养阳性角膜溃疡的细菌学特征,我们观察到革兰氏阳性细菌比革兰氏阴性细菌多。金黄色葡萄球菌中常见菌54株(30.68%)。讨论与结论:从目前的研究结果来看,细菌性角膜溃疡的发病率低于真菌性角膜溃疡。关于培养阳性角膜溃疡的细菌学特征,我们观察到革兰氏阳性细菌比革兰氏阴性细菌多。其中以金黄色葡萄球菌最为常见,其次为假单胞菌。葡萄球菌对万古霉素和阿奇霉素的敏感性为100%,对氟喹诺酮类药物的敏感性为60% ~ 80%。80%以上假单胞菌对氟喹诺酮类药物和氨基糖苷类药物敏感。77.27%的患者在最后随访时恢复。
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