Retrospective analysis of microbiological profile of patients with infective keratitis: North Indian perspective

Introduction: Infectious keratitis is among the leading causes of preventable blindness in developing countries. The epidemiological profile of infectious keratitis vary significantly from country to country and even area to area within the same country. Aim: This study was conducted to know the epidemiological pattern, predisposing risk factors involved and microbiological profile of the patients with corneal ulcer. Materials and Methods: A retrospective analysis of all the patients presenting to MMIMSR eye opd with corneal ulcer between Jan 2016 to June 2018 was done. The demographic data as well as epidemiological profile including history of trauma, duration of symptoms, predisposing risk factors, time taken to present to hospital was collected. The diagnosis was made based on clinical findings on Slit lamp examination as corneal epithelial defect with stromal infiltrate and microbiological investigations. Results: There were a total of 234 patients documented to have corneal ulcer. The mean age of presentation was 46 ± 18 years. Only 20 (8.6%) presents within a week of symptoms and 122 patients (52.1%) presented within 2 to 4 week of symptoms. A history of ocular trauma was present in about 150 patients (64%) out of which trauma with vegetative matter in 88 (58.67%) patients and trauma with non vegetative matter in 51 (34%) patients. Corneal scrapping was positive in 185 patients (79.04%) with KOH mount being positive in 152 patients (64.95%). Gram stain was positive for bacteria in 21 patients (8.97%) and 12 (5.12%) patients reported both bacteria and fungus. In 47 patients (20.08%), no organism was reported. Among the gram positive isolates, Staphylococcus epidermidis was the most frequent species. The most common fungal isolate reported was fusarium in 49 patients (26.48%) followed by Aspergillus in 19 patients (10.27%). Conclusion: Infective keratitis is a common cause of ocular morbidity with fungal corneal ulcer being the most frequent ulcer. Fusarium species in fungal corneal ulcer and staphylococcal epidermidis in bacterial corneal ulcer were the common isolates. A lack of knowledge about the magnitude of the problem, financial limitations and topographical constrains were implicated in delayed presentation to a health center.