Etiological spectrum of infectious keratitis in the era of MALDI-TOF-MS at a tertiary care hospital
Ranjana Rohilla, Suneeta Meena, Aroop Mohanty, Neeti Gupta, Neelam Kaistha, Pratima Gupta, Amit Mangla, Anshu Singh
Abstract
Background: Infectious Keratitis (Ik) Is A Potential Vision-Threatening Ocular Infection Caused By A Variety Of Microorganisms. Aim: To Explore Risk Factors And Etiological Agents Associated With Ik. Design: A Prospective Cross-Sectional Study In Which Corneal Scrapings From 120 Suspected Cases Were Evaluated At A Tertiary Health Care Institute From January To December 2019. Methods: Scrapings Were Subjected To Direct Microscopy, Culture, And Identification By Both Conventional Methods And Maldi-Tof-Ms. The Patient's Demographic Data And Predisposing Factors, If Any Were Recorded. Results: The Mean Age Of Patients Was 48.9 Years And Predisposing Factors Were Documented In 46% (55/120) Of Cases. Overall, Infective Etiology Could Be Established In 51% ( N = 61/120) Of Cases. Fungal Growth In 26% ( N = 31/120) Of Cases And Bacterial Growth In 22% ( N = 27/120) Of Cases Was Obtained. Growth Of More Than One Species Of Fungi Or Growth Of Bacteria Along With Fungus Were Observed In 2% ( N = 3/120) Of Cases. Of All The Fungal Isolates Obtained ( N = 34), The Most Common Isolate Was Fusarium (18/34) Followed By Aspergillus (8/34), Curvularia (4/34), Pseudallescheria Boydii (3/34), And Geotrichum (1/34). Among The Gram-Positive Bacterial Isolates ( N = 16), Staphyloccus Species (15/16) Were Isolated In Maximum Number Followed By Streptococcus Pneumoniae (1/16). Among The Gram-Negative Isolates ( N = 13), Pseudomonas Species (8/13) Were Isolated In Maximum Number Of Cases, Followed By Acinetobacter (3/13), Klebsiella Pneumoniae (1/13), And Escherichia Coli (1/13). Conclusion: For Initiating Appropriate Empirical Therapy, The Knowledge Of The Epidemiological Pattern Of Infectious Keratitis Of A Particular Geographical Region Is Crucial.