Bacterial Keratitis: Risk factors, clinical and microbiological study at a tertiary care hospital- A two year study

Aims: The purpose of the present study was to identify the common predisposing factors in the region and to identify the common bacterial agents associated with bacterial keratitis and outcome of the condition with regard to individual pathogen. Settings & Design: A prospective hospital based cross sectional study for a period of two years at a tertiary care hospital by the department of ophthalmology in association with department of Microbiology. Material & Methods: 350 patients above >5 years attending the OP of dept. of ophthalmology with clinical signs and symptoms of Bacterial keratitis were enrolled. Demographic data, duration of illness, clinical signs and symptoms were noted. Corneal smears and scrapings were collected by following standard protocol, and were transported to microbiology laboratory for processing and isolation of pathogens. The isolated pathogens were identified by standard biochemical tests and microbiological procedures by following CLSI guidelines. Results: 350 cases of bacterial keratitis with 200 males and 150 females were enrolled as cases, 26-45 years was the most common age group in the study. 31.1% were farmers, 52% belong to low socio economic status. 60.6% had a history of previous injury or surgery to the involved eye. History of corneal injury with paddy husk was noted in 60.57% of cases which was a major risk factor. 315 cases forming 90% of all cases were positive for growth. Staphylococcus aureus was the dominant isolate in the study. Aspergillus niger and Candida albicans were the fungal isolates in the study. Conclusion: Bacterial keratitis is one of the serious ocular conditions which require emergency care and management. Corneal injury remains as the major risk factor and associated ocular disorders, contact lens usage are other risk factors. Old age, anterior chamber infiltration, long duration of illness was associated with significant risk of poor visual outcome in the study. Any programmes directed against this condition should focus on the above factors in prevention of bacterial keratitis and to prevent complications.