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Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study

Yıl 2015, , 99 - 102, 06.02.2016
https://doi.org/10.5799/ahinjs.02.2015.03.0185

Öz

Objective: Corneal blindness is a major public health problem worldwide and mycotic keratitis is one of the predominant causes. Infection is difficult to treat and can lead to severe visual impairment or blindness. It is worldwide in distribution but is more common in tropics and subtropical region. Trauma is the major predisposing factor, followed by ocular or systemic defects, prior application of corticosteroids, and prolonged use of antibiotic eye drops. The purpose of this study was to document the clinical and epidemiological features and laboratory diagnosis of fungal corneal ulcer.

Methods: Patients who presented with clinically suspected corneal ulcer to ophthalmology department registered for the study. Data were collected through history and slit lamp examination. Corneal scrapping was performed. A portion of each scrapping was examined by direct microscopy. Another portion was inoculated directly on to solid culture media. Results: This study included 40 subjects with corneal ulcer based on clinical suspicion, of whom 14 cases were diagnosed with mycotic keratitis in the laboratory. Among these 14 cases, culture showed fungal growth only in 12 cases where the remaining cases were positive only by Potassium hydroxide (KOH) preparation. Males were more commonly affected and were mostly in the age group of 21 to 50 years. Aspergillus species and Fusarium species were the major isolates.

Conclusion: Rapid diagnosis and early institution of anti-fungal therapy is necessary to prevent ocular morbidity and blindness. The direct microscopy method by KOH is rapid, inexpensive and reliable method and culture helps in definite diagnosis and identification. J Microbiol Infect Dis 2015;5(3): 99-102

Key words: Mycotic keratitis, potassium hydroxide, Aspergillus species, Fusarium species.

Kaynakça

  • Rautaraya B, Sharma S, Kar S, et al. Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in Eastern India. BMC Ophthalmology 2011;11:39.
  • Panda A, Sharma N, Das G, et al. Mycotic keratitis in children:
  • Epidemiological and microbiological evaluation. Cornea 1997;16:295–299.
  • Dunlop AA, Wright ED, Howlader SA, et al. Suppurative corneal
  • ulceration in Bangladesh. A study of 142 cases examining the microbiological diagnosis, clinical and epidemiological features of bacterial and fungal keratitis. Aust N Z J Ophthalmol 1994 May;22:105–110.
  • Agarwal PK, Roy P, Das A, et al. Efficacy of topical and systemic
  • itraconazole as a broad-spectrum antifungal agent in
  • mycotic corneal ulcer. A preliminary study. Indian J Ophthalmol
  • ;49:173-176.
  • Agrawal V, Biswas J, Madhavan H N, et al. Current perspectives
  • in infectious keratitis. Indian J Ophthalmol 1994;42:171-192.
  • Bennett JE. Diagnosis and treatment of fungal infections. In:
  • Fauci AS, Braunwald E Isselbacher KJ, et al , Editors. Harrison’s
  • Principles of Internal Medicine. 14th ed. New York:McGraw-Hill; 1998. Vol 1, pp 1148-1154.
  • O’Day DM. Fungal keratitis. In: Pepose JS, Holland GN, Wilhemus
  • KR, editors. Ocular infections and immunity. St.Louis:Mosby;1997. p 263-264.
  • Williamson J, Gordon AM, Wood R, et al. Fungal flora of the
  • conjunctival sac in health and disease: influence of topical and systemic steroids. Br J Ophthalmol 1968;52:127–137.
  • Vemuganti GK, Garg P, Gopinathan U, et al. Evaluation of agent and host factors in progression of mycotic keratitis: A histopathological and microbiological study of 167 corneal
  • buttons. Ophthalmology 2002;109:1538-1546.
  • Poria V C, Bharad V R, Dongre D S, Kulkarni M V. Study of
  • mycotic keratitis. Indian J Ophthalmol 1985;33:229-231.
  • Sharma S, Srinivasan M, George C. The current status of
  • Fusarium species in mycotic keratitis in south India. Indian J
  • Med Microbiol 1993;11:140-147.
  • Chander J, Sharma A. Prevalence of fungal corneal ulcers in
  • Northern India. Infection 1994;22:207-209.
  • Dutta LC, Dutta D, Mohanty P, Sharma J. Study of fungal
  • keratitis. Indian J Ophthalmol 1981;29:407-409.
  • Varenkar MP, Borkar Shubhangi, Pinto MJM, Naik PA. Study of mycotic keratitis in Goa. Indian J Med Microbiol 1998;16:58-60.
  • Srinivasan M, Gonzales CA, George C, et al. Whitcher Epidemiology and aetiological diagnosis of corneal ulceration
  • in Madurai, south India. Br J Ophthalmol 1997;81:965–971.
  • Gopinathan U, Garg P, Fernandes M, et al. The epidemiological
  • features and laboratory results of fungal keratitis: A 10-year review at a referral eye care center in South India. Cornea 2002;21:555-559.
  • Fong CF, Tseng CH, Hu FR, et al. Clinical characteristics of microbial keratitis in a university hospital in Taiwan. Am J Ophthalmol 2004;137:329-336.
  • Mirshahi A, Ojaghi H, Aghashahi D, Jabarvand M. Fungal
  • dermatitis in patients at Farabi Hospital, Tehran. Bina1999;5:135-143.
  • Javadi MA, Hemati R, Muhammadi MM, et al. causes of fungal
  • corneal Keratitis and its management. Review of 23 cases from Labafinejad Medical Center (LMC). Bina 1996;2:38-54.
  • Bharathi M J, Ramakrishnan R, Vasu S, et al. Epidemiological
  • characteristics and laboratory diagnosis of fungal keratitis: A three-year study. Indian J Ophthalmol 2003;51:315-321.
  • Narsani AK, Nangdev PR, Surhio SA, et al. Demographic
  • pattern, risk factors, clinical and microbiological characteristics
  • of fungal keratitis. JLUMHS 2012;11:42-46.
  • Chander J, Singla N, Agnihotri N, et al. Keratomycosis in and
  • around Chandigarh: A five-year study from a north Indian tertiary care hospital. Indian J Pathol Microbiol 2008;51:304-306.
  • Kunimoto DY, Sharma S, Garg P, et al. Corneal ulceration
  • in the elderly in Hyderabad South India. Br J ophthalmol 2000;84:54-59.
  • Hagan M, Wright E, Newman M, et al. Causes of suppurative
  • keratitis in Ghana. Br J Ophthalmol 1995;79:1024–1028.
  • Forster RK, Rebell G. The diagnosis and management of
  • keratomycoses. Arch Ophthalmol 1975;93:975-978.
  • Thylefors B. Epidemiological patterns of ocular trauma. Aust NZ J Ophthalmol 1992;20:95-98.
  • Upadhyay MP, Karmachanya PCD, Koirala S, et al. Epidemiologic
  • characteristics, predisposing factors, and etiologic diagnosis of corneal ulceration in Nepal. Am J Ophthalmol 1991;111:92-99.
  • Schaefer F, Bruttin O, Zografos L, Guex-Crosier Y. Bacterial
  • keratitis: a prospective clinical and microbiological study. Br J Ophthalmol 2001l;85:842-847.
  • Kotigadde S, Ballal M, Jyothirlatha, et al. Mycotic keratitis : A
  • study in coastal Karnataka. Indian J Ophthalmol 1992;40:31-33.

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Yıl 2015, , 99 - 102, 06.02.2016
https://doi.org/10.5799/ahinjs.02.2015.03.0185

Öz

Amaç: Korneaya bağlı körlük bütün dünyada önemli bir halk sağlığı problemidir ve mikotik keratit önde gelen sebeplerinden biridir. Enfeksiyonun tedavi edilmesi zordur ve görme bozukluğuna ve körlüğe yol açabilir. Bu bütün dünyada görülebilmektedir ancak tropik ve subtropik bölgelerde yaygındır. Travma önemli kolaylaştırıcı faktördür ve ardından oküler ve sistemik yetmezlikler, önce kortikosteroit uygulamaları ve antibiyotikli göz damlalarının uzun süre kullanımı gelir. Bu çalışmanın amacı fungal korneal ülserin klinik ve epidemiyolojik özelliklerini ve laboratuvar tanısını dökümante etmektir.Yöntemler: Göz kliniğine klinik olarak korneal ülser şüphesi ile başvuran hastalar bu çalışmaya dahil edildi. Veriler hikayelerinden ve fizik muayene bulgularından toplandı. Korneal temizlik/ayıklama yapıldı. Çıkarılan her parça mikroskopta incelendi. Diğer bir parka doğrudan katı besiyerinde kültüre edildi. Bulgular: Çalışmaya klinik olarak kornea ülseri olan 40 olgu dahil edildi, bu olguların 14’ü laboratuvarda mikotik keratit olarak teşhis edildi. Bu 14 olgunun 12’sinde kültürde mantar üremesi oldu, geri kalan olgularda yalnızca potasyum hidroksit (KOH) preparatları pozitif idi. En çok etkilenenler 21-50 yaş arası erkekler idi. Aspergillus türleri ve Fusarium türleri en sık izole edilen türler idi. Sonuç: Hızlı tanı ve antifungal tedavinin erken başlanması gözün hastalıktan ve körlükten kurtulabilmesi için önemlidir. KOH ile direkt mikroskopik metot hızlı, ucuz ve güvenilirdir ve kültür tanı konulmasına ve kesinleştirilmesine yardım eder

Kaynakça

  • Rautaraya B, Sharma S, Kar S, et al. Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in Eastern India. BMC Ophthalmology 2011;11:39.
  • Panda A, Sharma N, Das G, et al. Mycotic keratitis in children:
  • Epidemiological and microbiological evaluation. Cornea 1997;16:295–299.
  • Dunlop AA, Wright ED, Howlader SA, et al. Suppurative corneal
  • ulceration in Bangladesh. A study of 142 cases examining the microbiological diagnosis, clinical and epidemiological features of bacterial and fungal keratitis. Aust N Z J Ophthalmol 1994 May;22:105–110.
  • Agarwal PK, Roy P, Das A, et al. Efficacy of topical and systemic
  • itraconazole as a broad-spectrum antifungal agent in
  • mycotic corneal ulcer. A preliminary study. Indian J Ophthalmol
  • ;49:173-176.
  • Agrawal V, Biswas J, Madhavan H N, et al. Current perspectives
  • in infectious keratitis. Indian J Ophthalmol 1994;42:171-192.
  • Bennett JE. Diagnosis and treatment of fungal infections. In:
  • Fauci AS, Braunwald E Isselbacher KJ, et al , Editors. Harrison’s
  • Principles of Internal Medicine. 14th ed. New York:McGraw-Hill; 1998. Vol 1, pp 1148-1154.
  • O’Day DM. Fungal keratitis. In: Pepose JS, Holland GN, Wilhemus
  • KR, editors. Ocular infections and immunity. St.Louis:Mosby;1997. p 263-264.
  • Williamson J, Gordon AM, Wood R, et al. Fungal flora of the
  • conjunctival sac in health and disease: influence of topical and systemic steroids. Br J Ophthalmol 1968;52:127–137.
  • Vemuganti GK, Garg P, Gopinathan U, et al. Evaluation of agent and host factors in progression of mycotic keratitis: A histopathological and microbiological study of 167 corneal
  • buttons. Ophthalmology 2002;109:1538-1546.
  • Poria V C, Bharad V R, Dongre D S, Kulkarni M V. Study of
  • mycotic keratitis. Indian J Ophthalmol 1985;33:229-231.
  • Sharma S, Srinivasan M, George C. The current status of
  • Fusarium species in mycotic keratitis in south India. Indian J
  • Med Microbiol 1993;11:140-147.
  • Chander J, Sharma A. Prevalence of fungal corneal ulcers in
  • Northern India. Infection 1994;22:207-209.
  • Dutta LC, Dutta D, Mohanty P, Sharma J. Study of fungal
  • keratitis. Indian J Ophthalmol 1981;29:407-409.
  • Varenkar MP, Borkar Shubhangi, Pinto MJM, Naik PA. Study of mycotic keratitis in Goa. Indian J Med Microbiol 1998;16:58-60.
  • Srinivasan M, Gonzales CA, George C, et al. Whitcher Epidemiology and aetiological diagnosis of corneal ulceration
  • in Madurai, south India. Br J Ophthalmol 1997;81:965–971.
  • Gopinathan U, Garg P, Fernandes M, et al. The epidemiological
  • features and laboratory results of fungal keratitis: A 10-year review at a referral eye care center in South India. Cornea 2002;21:555-559.
  • Fong CF, Tseng CH, Hu FR, et al. Clinical characteristics of microbial keratitis in a university hospital in Taiwan. Am J Ophthalmol 2004;137:329-336.
  • Mirshahi A, Ojaghi H, Aghashahi D, Jabarvand M. Fungal
  • dermatitis in patients at Farabi Hospital, Tehran. Bina1999;5:135-143.
  • Javadi MA, Hemati R, Muhammadi MM, et al. causes of fungal
  • corneal Keratitis and its management. Review of 23 cases from Labafinejad Medical Center (LMC). Bina 1996;2:38-54.
  • Bharathi M J, Ramakrishnan R, Vasu S, et al. Epidemiological
  • characteristics and laboratory diagnosis of fungal keratitis: A three-year study. Indian J Ophthalmol 2003;51:315-321.
  • Narsani AK, Nangdev PR, Surhio SA, et al. Demographic
  • pattern, risk factors, clinical and microbiological characteristics
  • of fungal keratitis. JLUMHS 2012;11:42-46.
  • Chander J, Singla N, Agnihotri N, et al. Keratomycosis in and
  • around Chandigarh: A five-year study from a north Indian tertiary care hospital. Indian J Pathol Microbiol 2008;51:304-306.
  • Kunimoto DY, Sharma S, Garg P, et al. Corneal ulceration
  • in the elderly in Hyderabad South India. Br J ophthalmol 2000;84:54-59.
  • Hagan M, Wright E, Newman M, et al. Causes of suppurative
  • keratitis in Ghana. Br J Ophthalmol 1995;79:1024–1028.
  • Forster RK, Rebell G. The diagnosis and management of
  • keratomycoses. Arch Ophthalmol 1975;93:975-978.
  • Thylefors B. Epidemiological patterns of ocular trauma. Aust NZ J Ophthalmol 1992;20:95-98.
  • Upadhyay MP, Karmachanya PCD, Koirala S, et al. Epidemiologic
  • characteristics, predisposing factors, and etiologic diagnosis of corneal ulceration in Nepal. Am J Ophthalmol 1991;111:92-99.
  • Schaefer F, Bruttin O, Zografos L, Guex-Crosier Y. Bacterial
  • keratitis: a prospective clinical and microbiological study. Br J Ophthalmol 2001l;85:842-847.
  • Kotigadde S, Ballal M, Jyothirlatha, et al. Mycotic keratitis : A
  • study in coastal Karnataka. Indian J Ophthalmol 1992;40:31-33.
Toplam 59 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Kısa Rapor
Yazarlar

Varsha Kalshetti Bu kişi benim

Surendra P. Wadgaonkar Bu kişi benim

Viraj M. Bhate Bu kişi benim

Rahul G. Wadile Bu kişi benim

Neha Haswani Bu kişi benim

S.t. Bothikar Bu kişi benim

Yayımlanma Tarihi 6 Şubat 2016
Yayımlandığı Sayı Yıl 2015

Kaynak Göster

APA Kalshetti, V., Wadgaonkar, S. P., Bhate, V. M., Wadile, R. G., vd. (2016). Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study. Journal of Microbiology and Infectious Diseases, 5(3), 99-102. https://doi.org/10.5799/ahinjs.02.2015.03.0185
AMA Kalshetti V, Wadgaonkar SP, Bhate VM, Wadile RG, Haswani N, Bothikar S. Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study. J Microbil Infect Dis. Şubat 2016;5(3):99-102. doi:10.5799/ahinjs.02.2015.03.0185
Chicago Kalshetti, Varsha, Surendra P. Wadgaonkar, Viraj M. Bhate, Rahul G. Wadile, Neha Haswani, ve S.t. Bothikar. “Microbiological Evaluation of Mycotic Keratitis in North Maharashtra, India: A Prospective Study”. Journal of Microbiology and Infectious Diseases 5, sy. 3 (Şubat 2016): 99-102. https://doi.org/10.5799/ahinjs.02.2015.03.0185.
EndNote Kalshetti V, Wadgaonkar SP, Bhate VM, Wadile RG, Haswani N, Bothikar S (01 Şubat 2016) Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study. Journal of Microbiology and Infectious Diseases 5 3 99–102.
IEEE V. Kalshetti, S. P. Wadgaonkar, V. M. Bhate, R. G. Wadile, N. Haswani, ve S. Bothikar, “Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study”, J Microbil Infect Dis, c. 5, sy. 3, ss. 99–102, 2016, doi: 10.5799/ahinjs.02.2015.03.0185.
ISNAD Kalshetti, Varsha vd. “Microbiological Evaluation of Mycotic Keratitis in North Maharashtra, India: A Prospective Study”. Journal of Microbiology and Infectious Diseases 5/3 (Şubat 2016), 99-102. https://doi.org/10.5799/ahinjs.02.2015.03.0185.
JAMA Kalshetti V, Wadgaonkar SP, Bhate VM, Wadile RG, Haswani N, Bothikar S. Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study. J Microbil Infect Dis. 2016;5:99–102.
MLA Kalshetti, Varsha vd. “Microbiological Evaluation of Mycotic Keratitis in North Maharashtra, India: A Prospective Study”. Journal of Microbiology and Infectious Diseases, c. 5, sy. 3, 2016, ss. 99-102, doi:10.5799/ahinjs.02.2015.03.0185.
Vancouver Kalshetti V, Wadgaonkar SP, Bhate VM, Wadile RG, Haswani N, Bothikar S. Microbiological evaluation of mycotic keratitis in north Maharashtra, India: A prospective study. J Microbil Infect Dis. 2016;5(3):99-102.