scholarly journals Organism Isolation in Corneal Ulcer- Utility of Different Techniques

2012 ◽  
Vol 52 (185) ◽  
Author(s):  
M Thapa ◽  
A K Sharma ◽  
D N Shah ◽  
S KC ◽  
S Shrestha
Keyword(s):  
Corneal Ulcer ◽  
Descriptive Study ◽  
Microbial Keratitis ◽  
Cross Sectional ◽  
Corneal Ulcers ◽  
Isolation Techniques ◽  
Corneal Scraping ◽  
Microbial Agents ◽  
Culture Negative ◽  
Corneal Biopsy

Introduction: Various techniques are available for isolation of microorganism in cases of microbial keratitis including conventional methods of scraping, re-scraping inoculation in different media and corneal biopsy. Methods: This was a cross sectional descriptive study conducted from February 2002 to July 2003. A total of 161 eyes of corneal ulcers were evaluated with scraping inoculation. Re-scraping and corneal biopsy were performed in those cases which did not grow any organism in the first scraping or which did not respond to initial treatment. Results: Microorganisms were isolated in 116 patients (72.04%) after first scraping. S pneumoniae was seen in 50(42%), Fusarium in 21(18%) and Aspergillus in 16(14%) cases. Re-scraping was done in 22 culture negative and non improving cases of which 14 (63.63%) showed isolation of organisms. After re-scraping, Fusarium and Aspergillus were isolated in four patients each (18% each) followed by S. pneumoniae in 3 (14%), S. aureus in 2 (9%), and Penicillium in 1(5%) case.Corneal biopsy was done in 10 cases with isolation of microbial agents in 7 (70%) with Aspergillus and S. aureus in three each, and S. epidermidis in 1(10%). Conclusions: Apart from conventional scraping, other isolation techniques should be considered in the treatment of non-responding and culture negative cases of corneal ulcers. Compared to bacteria, fungi are difficult to isolate in the first scraping and requires more frequent repeat scraping and corneal biopsy. Keywords: Corneal biopsy, corneal scraping, corneal ulcer, microbial keratitis, organismal isolation.

scholarly journals Microbial keratitis: A five years retrospective clinical study in tertiary eye hospital of eastern region of Nepal

2017 ◽  
Vol 4 (4) ◽  
pp. 118-125
Author(s):  
Lila Raj Puri ◽  
Gauri Shankar Shrestha
Keyword(s):  
Visual Acuity ◽  
Clinical Study ◽  
Clinical Features ◽  
Corneal Ulcer ◽  
Health Concern ◽  
Eye Drops ◽  
Microbial Keratitis ◽  
Corneal Ulcers ◽  
Retrospective Clinical Study ◽  
Corneal Scraping

Background: Corneal ulcer is a sight threatening disease of significant public health concern. Early diagnosis with microbiological identification of the causative organism and institution of the proper medical therapy are important for successful visual recovery.Objectives: To find out the demographic and predisposing factors associated with corneal ulcers, evaluate management of ulcers on the basis of clinical features and corneal scraping results.Methods: It was a retrospective clinical study conducted among 1897 subjects with microbial keratitis in Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from January 2010 to December 2014. Assessment included detailed eye examination with slit lamp for size, depth and location of ulcer, presenting visual acuity on internally illuminated Snellen’s chart, and corneal scrapings for Gram’s stain and 10% Potassium hydroxide wet mount. A standard treatment was delivered on the basis of clinical features and corneal scraping results. Subjects were evaluated subsequently after 48 hours, one week, two weeks, three weeks and four weeks of initiation of therapy. Non-responding cases were admitted to perform re-scraping and to modify therapy.Results: Majority of subjects (71.2%) belonged to the age group of 26 to 55 years  (71.2%), presented after two weeks (82.3%) and used non-prescription eye drops (71.9%) before visiting to the eye hospital. Ocular trauma (54.5%) was the most commonly reported predisposing factor. The central and paracentral ulcers comprised of 72.8% of ulcers withsize greater than 2mm in 2.7% and moderate ulcer in 71.1%. Microbiological test revealed fungal ulcers in 78.1% subjects. Presenting visual acuity better than 6/18 was reported in 7% only.Conclusion: Corneal ulcer was one of the commonly reported eye disease in Terai region of Nepal. Trauma is the commonest cause of corneal infection. Fungal corneal ulcers werecommonly noted.

scholarly journals A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mohammad Soleimani ◽  
Seyed Ali Tabatabaei ◽  
S. Saeed Mohammadi ◽  
Niloufar Valipour ◽  
Arash Mirzaei
Keyword(s):  
Pediatric Population ◽  
Cross Sectional Study ◽  
Eye Drops ◽  
Microbial Keratitis ◽  
Cyanoacrylate Glue ◽  
Cross Sectional ◽  
Under Five ◽  
Fluoroquinolone Antibiotics ◽  
Empiric Antibiotic ◽  
Corneal Scraping

Abstract Purpose To report characteristics of microbial keratitis in pediatric patients under five years. Methods Patients with infectious keratitis under the age of 5 years were included in this retrospective cross-sectional study for ten years. All patients were admitted and corneal scraping was performed in 81 children. Fortified empiric antibiotic eye drops including cefazolin (50 mg/cc) and amikacin (20 mg/cc) were started and the antibiotic regimen was continued or changed according to culture results. In the case of fungal keratitis, topical voriconazole (10 mg/cc) or natamycin (50 mg/cc) and topical chloramphenicol (5 mg/cc) were started. A tectonic procedure was done when corneal thinning or perforation was present. Results Ninety-Three Patients between 1 to 60 months with a mean age of 33 ± 18 months old with corneal ulcer were included in the study. The most common risk factor was trauma (40.9%) followed by contact lens use (8.6%). Cultures were negative for microbial growth in 28 (30.1%) patients. The most common pathogens were S. epidermidis (10.8%) and P. aeruginosa (10.8%). Fluoroquinolone antibiotics (ciprofloxacin; 93.8% sensitivity) were the most potent antibiotic against bacterial pathogens. Forty-one patients underwent tectonic procedures, which the most common ones were cyanoacrylate glue 18.3% followed by keratoplasty 16.1%. Conclusion This study emphasizes the role of trauma as the primary cause and S. epidermidis as the most frequent microorganism in pediatric keratitis; according to antibiogram results and poor cooperation of patients under five years, monotherapy with fluoroquinolones could be a good regimen in small non-central lesions without thinning.

scholarly journals Clinical Presentation and Antibiotic Susceptibility of Contact Lens Associated Microbial Keratitis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hesam Hedayati ◽  
Mahboubeh Ghaderpanah ◽  
Seyed Ahmad Rasoulinejad ◽  
Mohammad Montazeri
Keyword(s):  
Contact Lens ◽  
Antibiotic Susceptibility ◽  
Clinical Presentation ◽  
Causative Organism ◽  
Microbial Culture ◽  
Microbial Keratitis ◽  
Cross Sectional ◽  
Corneal Ulcers ◽  
Contact Lens Solution ◽  
Southwest Of Iran

Introduction.In recent years, the number of contact lens wearers has dramatically increased in Iran, particularly in youngsters. The purpose of current study was to assess the clinical presentation and antibiotic susceptibility of contact lens related microbial keratitis in Ahvaz, southwest of Iran.Methodology.A cross-sectional investigation of 26 patients (33 eyes) with contact lens induced corneal ulcers who were admitted to Imam Khomeini Hospital, Ahwaz City, from June 2012 to June 2013 was done. In order to study microbial culture and susceptibility of corneal ulcers, all of them were scraped.Results.Eight samples were reported as sterile.Pseudomonas aeruginosa(80%) in positive cultures was the most widely recognized causative organism isolated. This is followed byStaphylococcus aureus12% andEnterobacter8%. The results showed that 84% of the microorganism cases were sensitive to ciprofloxacin, while imipenem, meropenem, and ceftazidime were the second most effective antibiotics (76%).Conclusion.Results of current study show the importance of referring all contact lens wearers with suspected corneal infection to ophthalmologists for more cure. The corneal scraping culture and contact lens solution should be performed to guide antibiotic therapy.

scholarly journals Clinical and Etiological Profile of Mycotic Keratitis from a Tertiary Care Centre in South India

2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi
Keyword(s):  
Risk Factors ◽  
Corneal Ulcer ◽  
Fusarium Species ◽  
Tertiary Care ◽  
Government Medical College ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Corneal Ulcers ◽  
Prompt Treatment

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis

scholarly journals The prevalence of characteristic corneal ulcer patients in sanglah general hospital, in indonesia

2021 ◽  
pp. 81-84
Author(s):  
Sinta Wiranata ◽  
I Wayan Eka Sutyawan ◽  
I Putu Budhiastra
Keyword(s):  
General Hospital ◽  
Corneal Ulcer ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Corneal Ulcers ◽  
Analytical Research ◽  
Epidemiological Trends ◽  
The Relationship

Purpose: The purpose of the study was to perceive epidemiology, predisposing and varied risk factors, age, gender, profession, ulcus location, lateralization, visus category, medication. It also determines the relationship between each factor with infection and non-infection in Sanglah General Hospital, Bali. Methods: This is a cross-sectional study with method was used with 44 patients conferred in the Ophthalmology Department. The purposive sampling technique was also used in this study by considering exclusion and inclusion criteria. Then, the data were analyzed and assessed for medication and surgery for treatment between January 2017 and October 2018 using SPSS 25 version. Results: The mean age at diagnosis was 49.16±2.58 years, where samples of corneal ulcer infection made up 56.8%, and most of the cases occurred within the age group 30 - 60 years. Meanwhile, the infection mostly occurred in males, at a proportion of 77.3%, and based on the profession, 43.2% of the corneal ulcer were farmers. The most predisposing factor for infectious corneal ulcers was trauma, at 36.4%, as 39 patients had a central ulcus, where 47.7% were infectious, and 36.4% were non-infectious. However, not all the study variables were statistically significant (p > 0.05) with the patient's corneal. Conclusion: The findings of this study showed that corneal ulcer is common and mostly affects male. Furthermore, the epidemiological trends from developing countries with a predominance of infectious corneal ulcers were additional or less common. Therefore, more analysis with larger and specific sample sizes is required to be developed for resultant analytical research

scholarly journals Microbial Agents Causing Infective Corneal Ulcer and their Anti-microbial Susceptibility pattern

2019 ◽  
Vol 47 (2) ◽  
pp. 1-6
Author(s):  
Azima Aktar Jhuma ◽  
Md Moynul Haque ◽  
Jamil Ahmed ◽  
Shantanu Das ◽  
Tarun Kanti Paul ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Staphylococcus Epidermidis ◽  
Microbial Growth ◽  
Corneal Ulcer ◽  
Bacterial Pathogen ◽  
Fungal Growth ◽  
Penicillium Species ◽  
Corneal Ulcers ◽  
Microbial Agents ◽  
Susceptibility Patterns

This study was designed to identify the microbial agents causing infective corneal ulcer and to carry out the antimicrobial susceptibility patterns of isolated bacteria causing infective corneal ulcer. Out of 80 samples, 67 (83.75%) cases were positive by microscopy and culture. This study showed pure fungal growth in 39 (48.75%) cases, pure bacterial growth in 8 (10%) cases, mixed microbial growth (both fungi and bacteria) in 20 (25%) cases and no growth was observed in 13 (16.25%) cases. Among the fungal isolates, Aspergillus species was the leading agent detected in 37(46.3%) cases followed by Penicillium species in 7 (8.8%) instances. Pseudomonas aeruginosa was the most common bacterial pathogen found in 11 (13.8%) cases followed by Staphylococcus epidermidis present in 9 (11.3%) cases. Gentamicin, Ciprofloxacin and Levofloxacin were found to be better efficacious drugs against most of the bacterial pathogens noted in antimicrobial susceptibility test. This study showed that infective corneal ulcers are caused by both bacterial and fungal agents but fungal agents are more common. The findings of this study would help the ophthal- mologists in evidence based management of their patients of infective corneal ulcer. Bangladesh Med J. 2018 May; 47 (2): 1-6

Turicella otitidis: a rare agent causing microbial keratitis

2021 ◽  
Vol 14 (7) ◽  
pp. e241371
Author(s):  
Smruti Rekha Priyadarshini ◽  
Himanshu Sekhara Behera ◽  
Srikant Sahu ◽  
Anirban Dutta
Keyword(s):  
Literature Search ◽  
Corneal Ulcer ◽  
Tissue Adhesive ◽  
Microbial Keratitis ◽  
Gram Staining ◽  
Corynebacterium Species ◽  
Bacterial Aetiology ◽  
Corneal Scraping ◽  
Alkali Injury ◽  
Adhesive Application

A 10-year-old boy treated for alkali injury with multiple interventions presented with a perforated corneal ulcer with clinically suspected bacterial aetiology. Cornea scraping and tissue adhesive application were planned. During surgery, an eyelash was found embedded at the perforated site. Gram staining of corneal scraping revealed the presence of Gram-positive bacilli on the first day which later was identified as Turicella otitidis with culture followed by VITEK V.2.0 (Biomerieux) identification. The bacterium was found to be sensitive to amikacin, ciprofloxacin, cefazolin, gatifloxacin, moxifloxacin, ofloxacin and vancomycin antibiotics as per Clinical and Laboratory Standards Institute guidelines. Coryneform bacteria is a rare cause of keratitis, and this is the first reported case of microbial keratitis caused by one of the rare corynebacterium species T. otitidis to the best of our knowledge. Literature search does not reveal any specific ocular features typical to this organism. This case supports the growing evidence for pathogenicity of T. otitidis in ocular samples. This study demonstrates the utility of VITEK for the identification of rare pathogen and may facilitate the use of certain antibiotics in the treatment regimen of T. otitidis infections.

scholarly journals Amniotic membrane transplantation in a patient with an impending perforated corneal ulcer caused by Streptococcus mitis: a case report

2019 ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Yaa-Jyuhn James Meir ◽  
Lung-Kun Yeh ◽  
Hsin-Yuan Tan ◽  
Ching-Hsi Hsiao ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Corneal Ulcer ◽  
Amniotic Membrane Transplantation ◽  
Streptococcus Mitis ◽  
Continuous Administration ◽  
Corneal Ulcers ◽  
Corneal Erosion ◽  
Corneal Scraping ◽  
The Right ◽  
Viridans Group Streptococci

Abstract Background: Streptococcus mitis (S. mitis) belongs to the viridans group streptococci, which is rarely isolated as a causative pathogen of corneal ulcers. When S. mitis causes keratitis, penetrating keratoplasty (PK) might be necessary. Herein, we demonstrated that amniotic membrane transplantation (AMT) may be an easier procedure with acceptable outcomes and with fewer complications. Case presentation: A 63-year-old female presented with a right persistent corneal ulcer that she had suffered from for the past nine months. The culture of a corneal scraping yielded S. mitis. The right eye descemetocele decreased from 3 mm in diameter to 0.8 mm in diameter after the continuous administration of topical vancomycin and ceftriaxone for two weeks. Due to the slow healing, AMT was performed. Her corneal erosion healed and gradually became clear. Her visual acuity recovered from initially counting fingers to 20/200 17 months after AMT. Conclusion: This unusual case illustrated that antibiotics plus AMT may be an effective alternative treatment instead of PK to promote epithelialization and to reduce inflammation in corneas complicated by S. mitis keratitis.

scholarly journals Amniotic membrane transplantation in a patient with an impending perforated corneal ulcer caused by Streptococcus mitis: a case report

2019 ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Yaa-Jyuhn James Meir ◽  
Lung-Kun Yeh ◽  
Hsin-Yuan Tan ◽  
Ching-Hsi Hsiao ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Corneal Ulcer ◽  
Amniotic Membrane Transplantation ◽  
Streptococcus Mitis ◽  
Continuous Administration ◽  
Corneal Ulcers ◽  
Corneal Erosion ◽  
Corneal Scraping ◽  
The Right ◽  
Viridans Group Streptococci

Abstract Background: Streptococcus mitis (S. mitis) belongs to the viridans group streptococci, which is rarely isolated as a causative pathogen of corneal ulcers. When S. mitis causes keratitis, penetrating keratoplasty (PK) might be necessary. Herein, we demonstrated that amniotic membrane transplantation (AMT) may be an easier procedure with acceptable outcomes and with fewer complications. Case presentation: A 63-year-old female presented with a right persistent corneal ulcer that she had suffered from for the past nine months. The culture of a corneal scraping yielded S. mitis. The right eye descemetocele decreased from 3 mm in diameter to 0.8 mm in diameter after the continuous administration of topical vancomycin and ceftriaxone for two weeks. Due to the slow healing, AMT was performed. Her corneal erosion healed and gradually became clear. Her visual acuity recovered from initially counting fingers to 20/200 17 months after AMT. Conclusion: This unusual case illustrated that antibiotics plus AMT may be an effective alternative treatment instead of PK to promote epithelialization and to reduce inflammation in corneas complicated by S. mitis keratitis.

Laser Failure Isolation Techniques Demonstrated On Test Structures

2008 ◽  
Author(s):  
Frank S. Arnold
Keyword(s):  
Integrated Circuits ◽  
Laser Beam ◽  
Case Studies ◽  
Induced Resistance ◽  
Simple Test ◽  
Resistance Change ◽  
Cross Sectional ◽  
Beam Focusing ◽  
Isolation Techniques ◽  
Heating Effects

Abstract To be better prepared to use laser based failure isolation techniques on field failures of complex integrated circuits, simple test structures without any failures can be used to study Optical Beam Induced Resistance Change (OBIRCH) results. In this article, four case studies are presented on the following test structures: metal strap, contact string, VIA string, and comb test structure. Several experiments were done to investigate why an OBIRCH image was seen in certain areas of a VIA string and not in others. One experiment showed the OBRICH variation was not related to the cooling and heating effects of the topology, or laser beam focusing. A 4 point probe resistance measurement and cross-sectional views correlated with the OBIRCH results and proved OBIRCH was able to detect a variation in VIA fabrication.

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