Infectious Keratitis in Western Nepal: An Experience from a Tertiary Care Hospital

2018 ◽  
Author(s):  
Rajani Shrestha ◽  
Niranjan Nayak ◽  
Babita Gurung ◽  
Shishir Gokhale
Keyword(s):  
Antibiotic Susceptibility ◽  
Fungal Growth ◽  
Severe Form ◽  
Fungal Keratitis ◽  
Clinical Severity ◽  
Diffusion Method ◽  
Eye Drops ◽  
Infectious Keratitis ◽  
History Of ◽  
Predisposing Conditions

Abstract Background: Corneal blindness is a major public health problem worldwide and infectious keratitis is one of its leading causes. The aim was is to analyze the microbial etiology of corneal ulcers and to determine the antibiotic susceptibility pattern of bacterial isolates in order to find out the existing drug resistance pattern. Methods: Corneal scrapings were collected as per the standard procedure. All the isolates were identifies by conventional microbiological techniques. Antibiotic susceptibility testing was performed using disc diffusion method. Clinical grading of the ulcerative lesion was carried out by the recommended protocol. Results: Among the 84 cases of clinically diagnosed infectious keratitis investigated, 33 (39.3%) were farmers by occupation. All cases were reviewed for predisposing conditions and clinical severity. Ulcers were categorized as mild in 49 cases moderate in 12 and severe in 23 cases. Predisposing conditions were found in 55(65.5%) of the 84 cases. Forty-two cases showed culture positivity. Among these 42; 25 (29.7%) yielded fungal growth, 13(30.1%) yielded bacteria and the rest 4 (4.7%) showed mixed growth. Aspergillus spp. (10/29; 34.5%) were the commonest fungi isolated followed by Fusarium spp. (6/29; 20%). Similarly, Staphylococcus aureus, (8/17; 47%) was the most common among bacteria. Majority i.e 66.7% (26 of 39) of those having trauma, as the predisposing factor developed moderate to severe degree of corneal ulceration as compared to only 20% (9 of 45) of those without any history of trauma. (p<0.001). Interestingly, 20(68.9%) of the 29 cases that had yielded fungal growth on culture had had previous history of ocular trauma in contrast to only 19 (34.5%) of the 55 who had non-fungal origin of keratitis. (p=0.003). Fungal keratitis cases presented with more severe form of ulcerative lesions exhibiting more often with infiltrates and hypopion as compared to bacterial keratitis. Topical administration of fourth generation fluoroquinolone eye drops remained the most effective drug of choice with clinical improvement in all cases without any complications. Conclusions: Trauma with vegetative matter predisposed to most cases of fungal keratitis. Severe form of ulceration was noticed in patients with fungal infection. Surveillance of the antibiotic sensitivity is needed for quality patient management.

scholarly journals Infectious Keratitis in Western Nepal: An Experience from a Tertiary Care Hospital

2019 ◽  
Vol 21 (4) ◽  
pp. 288-293
Author(s):  
R Shrestha ◽  
N Nayak ◽  
B Gurung ◽  
S Gokhale
Keyword(s):  
Tertiary Care ◽  
Fungal Growth ◽  
Fungal Keratitis ◽  
Clinical Severity ◽  
Major Public Health Problem ◽  
Eye Drops ◽  
Care Hospital ◽  
Infectious Keratitis ◽  
History Of ◽  
Predisposing Conditions

Corneal blindness is a major public health problem worldwide and infectious keratitis remains a leading cause. The aim was to analyze the microbial etiology of corneal ulcers and to determine the antibiotic susceptibility pattern of bacterial isolates. Among 84 clinically diagnosed cases, 33 (39.3%) were farmers by occupation. All cases were reviewed for predisposing conditions and clinical severity. Ulcers were categorized as mild in 49 cases moderate in 12 and severe in 23 cases. Predisposing conditions were detected in 65.5% (55/84) of patients. Forty-two cases showed culture positivity. Among these 42; 25 (29.7%) yielded fungi, 13(30.1%) yielded bacteria and the rest 4 (4.7%) showed mixed growth, accounting for a total of 29 cases showing fungal growth, and 17 demonstrating bacterial growth. Aspergillus spp. (10/29; 34.5%) were the commonest fungi and Staphylococcus aureus, (8/17; 47%) was the most common among bacteria. Majority i.e 66.7% (26 of 39) of those having trauma as the predisposing factor developed moderate to severe degree of corneal ulceration as compared to only 20% (9 of 45) of those without any history of trauma and this difference was found to be statistically significant (p<0.001). Interestingly, 20(68.9%) of 29 cases that yielded fungal growth on culture had previous history of ocular trauma in contrast to only 19 (34.5%) of 55 who had non-fungal keratitis (p=0.003). It was also observed that significantly higher number of fungal keratits cases exhibited pronounced degree of clinical severity, as compared to cases without any fungal aetiology (p<0.001) Topical administration of fourth generation fluoroquinolone eye drops remained the most effective drug of choice as far as the clinical outcome of bacterial keratitis was concerned. Trauma with vegetative matter predisposed to most cases of fungal keratitis. Severe form of ulceration was noticed in patients with fungal infection.

Bacterial and Fungal Keratitis: A Retrospective Analysis at a University Hospital in Switzerland

2019 ◽  
Vol 236 (04) ◽  
pp. 358-365 ◽  
Author(s):  
Alexandra Bograd ◽  
Theo Seiler ◽  
Sara Droz ◽  
Stefan Zimmerli ◽  
Beatrice Früh ◽  
...  
Keyword(s):  
Contact Lenses ◽  
Topical Therapy ◽  
Fungal Growth ◽  
Fungal Keratitis ◽  
University Hospital ◽  
Fusarium Spp ◽  
Candida Spp ◽  
Coagulase Negative Staphylococci ◽  
History Of ◽  
Time Periods

Abstract Background Infectious keratitis is a serious corneal disease and may lead to permanent visual deterioration if not treated rapidly and effectively. In order to determine possible changes in the spectrum of pathogens over time, we evaluated the pathogenic organisms of keratitis at a university hospital in Switzerland, comparing two time periods within a decade. Methods In this retrospective study, 417 patients with the clinical diagnosis of bacterial or fungal keratitis in 2006/07 and 2015/16 were enrolled. In an additional analysis, all cases of fungal keratitis between 2006 and 2016 were evaluated. Collected parameters were age, gender, side, use of contact lenses, systemic, neurological and ocular diseases, trauma, previous surgery, and systemic and topical therapy before presentation. In each patient, microbiological results of corneal smears such as growth and antibiotic resistance were analysed. Results A total of 163 and 254 eyes were included in 2006/07 and 2015/16, respectively. In 2006/07, a culture of smears revealed a bacterial cause in 70 eyes (42.9%) and a fungal cause in 4 eyes (2.5%), whereas in 2015/16, bacterial growth was found in 115 eyes (45.3%) and fungal growth in 6 eyes (2.4%). The most common bacteria in 2006/07 and 2015/16 were coagulase-negative Staphylococci (44.3 vs. 49.6%), Pseudomonas aeruginosa (18.6 vs. 13.9%), Staphylococcus aureus (10 vs. 16.5%), Corynebacterium spp. (8.6 vs. 5.2%), and Moraxella spp. (7.1 vs. 9.6%). Candida parapsilosis was the most common fungal isolate in both groups (25 vs. 33.3%). Between 2006 and 2016, fungal keratitis was found in 37 eyes (Candida spp. n = 11, Fusarium spp. n = 11, Aspergillus spp. n = 5, others n = 10). All patients with Fusarium spp. keratitis had a history of wearing contact lenses. Conclusion The most commonly isolated bacterial organisms were Staphylococci and Pseudomonas spp., whereas fungal keratitis was mainly due to Candida spp. or Fusarium spp. No relevant variation in causative pathogens was observed between the two time periods.

scholarly journals Keratitis due to a Rare Fungus Colletotrichum dematium: A Case Report

2021 ◽  
Author(s):  
Archana Bhimrao Wankhade ◽  
Vijaya Sahu ◽  
Pratibha Sharma ◽  
Padma Das
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Geographical Distribution ◽  
Male Patient ◽  
Clinical Condition ◽  
Fungal Keratitis ◽  
Eye Drops ◽  
Microbiological Investigation ◽  
Colletotrichum Dematium ◽  
History Of

Keratitis is a very serious clinical condition caused by bacteria, fungi or parasites. It is associated with serious complications like blindness or endophthalmitis if remained undiagnosed. A 42-year-old male patient with the history of foreign body inoculation presented with mild pain and redness. After clinical examination, fungal keratitis was diagnosed. Corneal scrapping was sent for microbiological investigation. A very rare fungi Colletotrichum dematium was isolated and identified. Patient was managed with Natamycin tab fluconazole and atropin eye drops. To know the geographical distribution of the rare fungi, more and more cases should be studied and reported, which will help in management of rare fungi and standardisation of therapy.

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 21-31
Author(s):  
Nguyen Phan ◽  
Hien Pham ◽  
Thuc Nguyen ◽  
Hoai Nguyen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Nasal Carriage ◽  
Resistance Rate ◽  
High Rate ◽  
Weight History ◽  
Potential Risk Factors ◽  
History Of ◽  
Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

Antimicrobial Susceptibility Pattern of Staphylococcus Species from Clinical Samples

2020 ◽  
Author(s):  
Muhammad Ali
Keyword(s):  
Clavulanic Acid ◽  
Antibiotic Susceptibility ◽  
Vaginal Swab ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Susceptibility Pattern ◽  
Mannitol Salt Agar ◽  
Agar Disc ◽  
Microbiological Methods ◽  
Amoxicillin Clavulanic Acid

The research was aimed to evaluate the antibiotic susceptibility pattern of Staphylococcus species from clinical samples obtained from some hospitals in Kano metropolis, Nigeria. The ear swab, high vaginal swab (HVS), wound swab and urine samples from the patients attending the hospitals were collected and inoculated onto the surface of freshly prepared Nutrient agar for bacterial isolation. The bacteria isolated were identified by conventional microbiological methods namely; Gram staining, biochemical test (such as catalase, coagulase, and DNase test), mannitol salt agar and heamolysis test. The isolates were subjected to antibiotic susceptibility testing using the agar disc diffusion method. The result showed that S. aureus was highly susceptible to Ciprofloxacin 105 (68.63%), Gentamicin 102 (66.67%), Levofloxacin 95 (62.08%) and Amikacin 90 (58.82%), S. epidermidis was highly susceptible to Gentamicin 13 (61.90%), Levofloxacin 12 (57.14%) and Nitrofurantoin 11 (52.38%) while S. saprophyticus was highly susceptible to Cefoxitin 7 (77.78%), Gentamicin 6 (66.67%) and Nitrofurantoin 5 (55.56%). On the other hand, S. aureus was highly resistant to Cefuroxime 153 (100%), Ceftazidime 150 (98.04%), Amoxicillin/clavulanic acid 120 (78.43%) and Cloxacillin 111 (72.55%), S. epidermidis was highly resistant to Ceftazidime 20 (95.24%), Cloxacillin 19 (90.48%) then Cefoxitin, Erythromycin and Amoxicillin/clavulanic acid with 15 (71.43%) both. S. saprophyticus was highly resistant to Cefepime 9 (100%), Cloxacillin 8 (88.89%), Ceftazidime 7 (77.78%), Imipenem and Erythromycin with 6 (66.67%) respectively. There is a statistical difference in the sensitivity of the isolates against the antibiotics used at p<0.05. It is concluded that Staphylococcus species develop resistance to some classes of antibiotics.

scholarly journals THU0597 CORNEAL MELT - DON’T ALWAYS BLAME RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 540.3-540
Author(s):  
A. Munir ◽  
C. Sheehy
Keyword(s):  
Rheumatoid Arthritis ◽  
Renal Biopsy ◽  
Systemic Vasculitis ◽  
Lower Lobe ◽  
Visual Outcome ◽  
Eye Drops ◽  
Poor Visual Outcome ◽  
Methyl Prednisolone ◽  
History Of ◽  
And Function

Background:Corneal melt is a rare inflammatory disease of the peripheral cornea; it may lead to perforation of the globe and visual failure. Corneal melt can be a manifestation of systemic vasculitis in patients with RA and other conditions, such as cancer. Without early and aggressive treatment it may be associated with a poor visual outcome and a high mortality. It has been reported in patients with stable RA.Objectives:A case report in a patient with long standing but well controlled Rheumatoid Arthritis (RA) and metastatic disease.Methods:A 75 year old male with a background of sero positive Rheumatoid Arthritis for more than 10 years presented to the Eye Casualty with a two week history of a painful left red eye. His other medical history was significant for Stage IIB poorly differentiated cancer of the left lower lobe. Left lower lobectomy with a patch of diaphragm resected. Intratumoural lymphovascular invasion noted. He completed Adjuvant Carboplatin/Vinorelbine chemotherapy September, 2017. He had DVT proximal left leg 22ndof September, 2017. Follow up CT in 2018 demonstrated a right renal upper pole lesion for which he was awaiting biopsy with?metastatic lung disease vs primary renal carcinoma. His RA was well controlled on Methotrexate 10mg weekly. He had been treated by the ophthalmology team for left marginal Keratitis for the prior 2 months with steroid eye drops without significant improvement. On presentation to ED, he described sharp eye pain, waking him from the sleep, associated with watery discharge and photophobia. Examination showed corneal melt in left eye involving 25% of inferior portion of the cornea and spastic entropion with injecting eye lashes. He had no active joints and there were no other signs of vasculitis. CRP was 4.1. He had a negative ANA and ANCA; viral swabs were negative. He was admitted under the medical team. Intravenous Methyl Prednisolone was started. The patient felt better after 5 days of Methyl Prednisolone. Left temporary tarsorrhaphy was done by Ophthalmology. Cyclophosphamide was initiated after discussion with Oncologist pending the result of the renal biopsy. Patient was discharged after 5 days of admission in the hospitalResults:The renal biopsy was positive for metastatic Squamous cell carcinoma of lung. Cyclophosphamide was withdrawn and he was started on Carboplatin/Gemcitabine. The corneal melt improved with complete resolution of his visual symptoms.Conclusion:In this case, although the history of RA was felt by the ophthalmology team to be the most likely association with the corneal melt, we would argue the oncological diagnoses were likely the driving force behind the presentation.References:[1]Sule A, Balakrishnan C, Gaitonde S, Mittal G, Pathan E, Gokhale NS, et al. Rheumatoid corneal melt. Rheumatology (Oxford)2002;41:705–6.[2]S. Yano, K. Kondo, M. Yamaguchi et al., “Distribution and function of EGFR in human tissue and the effect of EGFR tyrosine kinase inhibition,” Anticancer Research, vol. 23, no. 5, pp. 3639–3650, 2003.Disclosure of Interests:None declared

scholarly journals Preliminary Results on the Prevalence of Salmonella Spp. in Marine Animals Stranded in Sicilian Coasts: Antibiotic Susceptibility Profile and ARGs Detection in the Isolated Strains

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 930
Author(s):  
Delia Gambino ◽  
Sonia Sciortino ◽  
Sergio Migliore ◽  
Lucia Galuppo ◽  
Roberto Puleio ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Antibiotic Susceptibility ◽  
Antibiotic Resistance Genes ◽  
Diffusion Method ◽  
Salmonella Spp ◽  
Marine Animals ◽  
Disk Diffusion Method ◽  
Phenotypic Resistance ◽  
Low Prevalence

The presence of Salmonella spp. in marine animals is a consequence of contamination from terrestrial sources (human activities and animals). Bacteria present in marine environments, including Salmonella spp., can be antibiotic resistant or harbor resistance genes. In this study, Salmonella spp. detection was performed on 176 marine animals stranded in the Sicilian coasts (south Italy). Antibiotic susceptibility, by disk diffusion method and MIC determination, and antibiotic resistance genes, by molecular methods (PCR) of the Salmonella spp. strains, were evaluated. We isolated Salmonella spp. in three animals, though no pathological signs were detected. Our results showed a low prevalence of Salmonella spp. (1.7%) and a low incidence of phenotypic resistance in three Salmonella spp. strains isolated. Indeed, of the three strains, only Salmonella subsp. enterica serovar Typhimurium from S. coeruleoalba and M. mobular showed phenotypic resistance: the first to ampicillin, tetracycline, and sulphamethoxazole, while the latter only to sulphamethoxazole. However, all strains harbored resistance genes (blaTEM, blaOXA, tet(A), tet(D), tet(E), sulI, and sulII). Although the low prevalence of Salmonella spp. found in this study does not represent a relevant health issue, our data contribute to the collection of information on the spread of ARGs, elements involved in antibiotic resistance, now considered a zoonosis in a One Health approach.

scholarly journals Detection of Methicillin Resistant Staphylococcus aureus in Dairy Products and Anterior Nares of Dairy Workers

2019 ◽  
Vol 6 ◽  
pp. 59-62
Author(s):  
Ranjana K.C. ◽  
Ganga Timilsina ◽  
Anjana Singh ◽  
Supriya Sharma
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Dairy Products ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Dairy Product ◽  
Control Measures ◽  
Diffusion Method ◽  
Mannitol Salt Agar ◽  
Methicillin Resistant ◽  
Dairy Workers

Objectives: To isolate methicillin resistant Staphylococcus aureus (MRSA) from anterior nares of dairy workers and dairy products and assess the antibiotic susceptibility pattern of the isolates. Methods: Swab samples collected from anterior nares of dairy workers and dairy product (butter) were inoculated into mannitol salt agar and incubated at 37ºC for 24 hours. Identification was done based on colony characteristics, Gram's staining, catalase, oxidase and coagulase test. Antibiotic susceptibility testing was done by modified Kirby Bauer disc diffusion method. MRSA was confirmed by using cefoxitin disc. Results: A total of 109 S. aureus (98 from dairy workers and 11 from butter samples) were isolated. Out of them 32 MRSA were isolated from dairy workers and 4 from butter samples. The association between age group and MRSA was found insignificant (p = 0.115). The association of MRSA between male and female workers was found significant (>0.05). About 86% of the MRSA isolates were susceptible to Gentamicin (86.11%) followed by Ciprofloxacin (77.78%). Conclusion: Detection of MRSA among dairy workers and dairy products warrants proper handling and adequate control measures to prevent transmission of MRSA from dairy industry.

Prevalence, Antibiogram, and cdt Genes of Toxigenic Campylobacter jejuni in Salad Style Vegetables (Ulam) at Farms and Retail Outlets in Terengganu

2015 ◽  
Vol 78 (1) ◽  
pp. 65-71 ◽  
Author(s):  
MOHD IKHSAN KHALID ◽  
JOHN YEW HUAT TANG ◽  
NABILA HUDA BAHARUDDIN ◽  
NASIHA SHAKINA RAHMAN ◽  
NURUL FAIZZAH RAHIMI ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Multiplex Pcr ◽  
Campylobacter Jejuni ◽  
Antibiotic Susceptibility ◽  
Penicillin G ◽  
Diffusion Method ◽  
Cytolethal Distending Toxin ◽  
Disk Diffusion Method ◽  
Retail Outlets ◽  
Pcr Method

The present study was conducted to investigate the prevalence and antibiotic resistance among Campylobacter jejuni in ulam at farms and retail outlets located in Kuala Terengganu, Malaysia. A total of 526 samples (ulam, soil, and fertilizer) were investigated for the presence of C. jejuni and the gene for cytolethal distending toxin (cdt) by using a multiplex PCR method. Antibiotic susceptibility to 10 types of antibiotics was determined using the disk diffusion method for 33 C. jejuni isolates. The average prevalence of contaminated samples from farms, wet markets, and supermarkets was 35.29, 52.66, and 69.88%, respectively. The cdt gene was not detected in 24 of the 33 C. jejuni isolates, but 9 isolates harbored cdtC. Antibiotic resistance in C. jejuni isolates was highest to penicillin G (96.97% of isolates) followed by vancomycin (87.88%), ampicillin (75.76%), erythromycin (60.61%), tetracycline (9.09%), amikacin (6.06%), and norfloxacin (3.03%); none of the isolates were resistant to ciprofloxacin, enrofloxacin, and gentamicin. In this study, C. jejuni was present in ulam, and some isolates were highly resistant to some antibiotics but not to quinolones. Thus, appropriate attention and measures are required to prevent C. jejuni contamination on farms and at retail outlets.

A case of nodular episcleritis mimicking a solitary giant episcleral mass

2021 ◽  
pp. 112067212110528
Author(s):  
Lan Zhou ◽  
Juanjuan Wang ◽  
Guihua Xu ◽  
Dingding Wang ◽  
Xiaoyi Wang ◽  
...  
Keyword(s):  
Topical Steroid ◽  
Inflammatory Cells ◽  
Systemic Hypertension ◽  
Eye Drops ◽  
Definite Diagnosis ◽  
Imaging Studies ◽  
Immunohistochemical Examination ◽  
History Of ◽  
Inflammatory Drugs

Purpose To describe an atypical nodular episcleritis mimicking a solitary giant episcleral mass, which is not attributed to any systemic diseases and identified only after immunohistochemical examination. Case report A sixty-year-old Chinese woman with systemic hypertension presented with 6-month history of giant, solitary and redness epibulbar mass arising from the superior aspect of her left eye. The lesion gradually enlarged, even with 6-month history of irregular topical steroid eye drops treatment. Imaging studies and laboratory test revealed a 10 mm × 8 mm episcleral mass absence of any infection indicator and autoimmune antibody changes. The mass was completely removed before its extension through the deep scleral, histopathologic examination revealed a nodular episcleritis composed of various chronic inflammatory cells infiltration. Topical steroid eye drops treatment combined with oral steroidal anti-inflammatory drugs was then administrated regularly for 1 month, and no recurrence occurred after 1-year follow-up. Conclusion Nodular anterior episcleritis is characterized by underlying chronic inflammation of the anterior episclera and can be presented as asymptomatic episcleral mass. Besides a thorough investigation systemically, tissue biopsy is required for definite diagnosis.

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