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Published in: BMC Ophthalmology 1/2016

Open Access 01-12-2016 | Research article

Microbiological profile of corneal ulcer cases diagnosed in a tertiary care ophthalmological institute in Nepal

Authors: Sharmila Suwal, Dinesh Bhandari, Pratigya Thapa, Mohan Krishna Shrestha, Jyoti Amatya

Published in: BMC Ophthalmology | Issue 1/2016

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Abstract

Background

Corneal ulcer, a major cause of monocular blindness in developing countries has consistently been listed as the major cause of blindness and visual disability in many of the developing nations in Asia, Africa and the Middle East, ranking second only to cataract. This study was carried out to determine the microbiological profile of corneal ulcer cases diagnosed among patients visiting Tilganga Institute of Ophthalmology (TIO), Nepal.

Methods

A total of 101 corneal scrapping samples were tested for routine culture and antibiotic susceptibility at the pathology department of TIO Nepal from April to October 2014. Microorganisms were identified by using standard microbiological procedures following the manual of American Society for Microbiology (ASM) and their antibiotic susceptibility test, performed by Kirby-Bauer disc diffusion method in conformity with the CLSI guideline.

Results

Out of 101 samples analyzed, 44.6% (45/101) showed positive growth with bacterial isolates i.e., 56% (25/45), more prevalent than fungus i.e., 44% (20/45). Among bacteria Streptococcus pneumoniae (31.1%, N = 14) was isolated in highest number whereas Fusarium (13.4%, N = 6) was the most common fungus species. Pseudomonas aeruginosa was the only Gram negative bacteria isolated from corneal ulcer cases. All bacterial isolates were found to be susceptible to the quinolone group of antibiotics (moxifloxacin followed by ofloxacin and ciprofloxacin).

Conclusions

These findings showcase the current trend in the microbiological etiology of corneal ulcer in Nepal, which have important public health implications for the treatment as well as prevention of corneal ulceration in the developing world.
Literature
1.
go back to reference Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: A global perspective. Bull World Health Organ. 2001;79(3):214–21.PubMedPubMedCentral Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: A global perspective. Bull World Health Organ. 2001;79(3):214–21.PubMedPubMedCentral
5.
go back to reference Bharathi MJ, Ramakrishnan R, Meenakshi R, Shivakumar C, Raj DL. Analysis of the risk factors predisposing to fungal, bacterial & Acanthamoeba keratitis in south India. Indian J Med Res. 2009;130(December):749–57.PubMed Bharathi MJ, Ramakrishnan R, Meenakshi R, Shivakumar C, Raj DL. Analysis of the risk factors predisposing to fungal, bacterial & Acanthamoeba keratitis in south India. Indian J Med Res. 2009;130(December):749–57.PubMed
8.
go back to reference Deorukhkar S, Katiyar R, Saini S. Epidemiological features and laboratory results of bacterial and fungal keratitis: A five-year study at a rural tertiary-care hospital in western Maharashtra, India. Singap Med J. 2012;53(4):264–7. Deorukhkar S, Katiyar R, Saini S. Epidemiological features and laboratory results of bacterial and fungal keratitis: A five-year study at a rural tertiary-care hospital in western Maharashtra, India. Singap Med J. 2012;53(4):264–7.
9.
go back to reference Patel A, Hammersmith K. Contact lens-related microbial keratitis: recent outbreaks. Curr Opin Ophthalmol. 2008;19:302–6.CrossRefPubMed Patel A, Hammersmith K. Contact lens-related microbial keratitis: recent outbreaks. Curr Opin Ophthalmol. 2008;19:302–6.CrossRefPubMed
12.
go back to reference Feilmeier MR, Sivaraman KR, Oliva M, Tabin GC, Gurung R. Etiologic diagnosis of corneal ulceration at a tertiary eye center in Kathmandu, Nepal. Cornea. 2010;29(12):1380–5.CrossRefPubMed Feilmeier MR, Sivaraman KR, Oliva M, Tabin GC, Gurung R. Etiologic diagnosis of corneal ulceration at a tertiary eye center in Kathmandu, Nepal. Cornea. 2010;29(12):1380–5.CrossRefPubMed
13.
go back to reference Upadhyay MP, Karmacharya PC, Koirala S, Shah DN, Shakya S, Shrestha JK, et al. The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal. Br J Ophthalmol. 2001;85(4):388–92.CrossRefPubMedPubMedCentral Upadhyay MP, Karmacharya PC, Koirala S, Shah DN, Shakya S, Shrestha JK, et al. The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal. Br J Ophthalmol. 2001;85(4):388–92.CrossRefPubMedPubMedCentral
14.
go back to reference Baron EJ. Manual of Clinical Microbiology. 9th ed. Murray Patrick R, Baron Eleen JO, editors. Virginia: ASM Press; 2007. Baron EJ. Manual of Clinical Microbiology. 9th ed. Murray Patrick R, Baron Eleen JO, editors. Virginia: ASM Press; 2007.
16.
go back to reference Testing S. M100-S25 Performance Standards for Antimicrobial [Internet]. Wayne: Clinical Laboratory Standard Institute; 2015. Available from: http://www.clsi.org. Testing S. M100-S25 Performance Standards for Antimicrobial [Internet]. Wayne: Clinical Laboratory Standard Institute; 2015. Available from: http://​www.​clsi.​org.
17.
go back to reference Lavaju P, Arya SK, Khanal B, Amatya RPS. Demograhic pattern, clinical features and treatment outcome of patients with infective keratitis in the eastern region of Nepal. Nepal J Ophthalmol. 2009;1(2):101–6.PubMed Lavaju P, Arya SK, Khanal B, Amatya RPS. Demograhic pattern, clinical features and treatment outcome of patients with infective keratitis in the eastern region of Nepal. Nepal J Ophthalmol. 2009;1(2):101–6.PubMed
20.
go back to reference Karthikeyan RS, Priya JL, Leal SM, Toska J, Rietsch A, Prajna V, et al. Host Response and Bacterial Virulence Factor Expression in Pseudomonas aeruginosa and Streptococcus pneumoniae Corneal Ulcers. PLoS One. 2013;8(6):2–9.CrossRef Karthikeyan RS, Priya JL, Leal SM, Toska J, Rietsch A, Prajna V, et al. Host Response and Bacterial Virulence Factor Expression in Pseudomonas aeruginosa and Streptococcus pneumoniae Corneal Ulcers. PLoS One. 2013;8(6):2–9.CrossRef
21.
go back to reference Nentwich MM, Bordón M, di Martino DS, Campuzano AR, Torres WM, Laspina F, et al. Clinical and epidemiological characteristics of infectious keratitis in Paraguay. Int Ophthalmol. 2015;35(3):341–6.CrossRefPubMed Nentwich MM, Bordón M, di Martino DS, Campuzano AR, Torres WM, Laspina F, et al. Clinical and epidemiological characteristics of infectious keratitis in Paraguay. Int Ophthalmol. 2015;35(3):341–6.CrossRefPubMed
22.
go back to reference Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Palaniappan R. Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study. Indian J Ophthalmol. 2003;51(December):315–21.PubMed Bharathi MJ, Ramakrishnan R, Vasu S, Meenakshi R, Palaniappan R. Epidemiological characteristics and laboratory diagnosis of fungal keratitis. A three-year study. Indian J Ophthalmol. 2003;51(December):315–21.PubMed
23.
go back to reference Basak SK, Basak S, Mohanta A, Bhowmick A. Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, eastern India. Indian J Ophthalmol. 2005;53(March):17–22.CrossRefPubMed Basak SK, Basak S, Mohanta A, Bhowmick A. Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, eastern India. Indian J Ophthalmol. 2005;53(March):17–22.CrossRefPubMed
24.
go back to reference Mallika PS, Tan AK, Asok T, Faisal HA, Aziz S, Intan G. Pattern of ocular trauma in Kuching, Malaysia. Malays Fam Physician. 2008;3(3):140–5.PubMedPubMedCentral Mallika PS, Tan AK, Asok T, Faisal HA, Aziz S, Intan G. Pattern of ocular trauma in Kuching, Malaysia. Malays Fam Physician. 2008;3(3):140–5.PubMedPubMedCentral
Metadata
Title
Microbiological profile of corneal ulcer cases diagnosed in a tertiary care ophthalmological institute in Nepal
Authors
Sharmila Suwal
Dinesh Bhandari
Pratigya Thapa
Mohan Krishna Shrestha
Jyoti Amatya
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2016
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-016-0388-9

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