ABSTRACT
Background: Nonfermentative gram-negative bacilli (NFGB) have emerged as a major cause of nosocomial infections.This study was undertaken to know the prevalence of nonfermenters isolated from different clinical samples along with their susceptibility profile. Material and methods: Conventional bacteriological methods were used for identification and susceptibility testing of nonfermenters. Susceptibility testing was performed by methods as recommended by Clinical Laboratory Standard Institute (CLSI). Results: Out of the total 1,650 clinical samples received NFGB were found in 201 samples with an isolation rate of 12.18%. Nonfermenters isolated were Pseudomonas aeruginosa (50.24%), Acinetobacter baumannii (24.87%), Acinetobacter lowffii (5.47%), Pseudomonas fluorescens (1.49%), Pseudomonas stutzeri (1.99%), Burkholderia cepacia (6.96%), Stenotrophomonas maltophilia (2.98%), Achromobacter xylosoxidan (3.98%) and Shewanella putrefaciens (1.99%). Most of the isolated organisms were multidrugresistant (MDR). P. aerurginosa showed good sensitivity to imipenem (91.08%), cefoperazone sulbactum (68.31%) combination, amikacin (69.30%) and colistin (100%). A. baumannii showed 90% sensitivity to imipenem and 94% to colistin. Conclusion: Our study showed that prevalence of NFGB amongst different clinical isolates is significantly high especially in this part of the world and these organisms are often MDR. In this scenario, we propose all laboratory samples should be screened for NFGB even in clinically unsuspected cases. P. aeruginosa showed good sensitivity to colistin, imipenem, amikacin and cefoperazone sulbactum combination while A. baumannii showed good sensitivity to imipenem and colistin.
ABSTRACT
PURPOSE: To evaluate the efficacy of topical (1%) and systemic itraconazole against common fungi such as Aspergillus and other filamentous fungi that cause mycotic corneal ulcer. METHODS: A prospective randomised, controlled study was done in 54 clinically suspected cases of fungal keratitis of which 44 were culture proven. Half the cases (n=27) with superficial involvement were treated with only topical itraconazole (1%) and the other half were treated with both topical and systemic itraconazole. RESULTS: Aspergillus, Penicillium and Fusarium were the most common fungi isolated. The ulcer resolved in 42 eyes (77%) and 12 eyes (23%) did not respond well to treatment. Four of 12 non-responding eyes were caused by Fusarium species. CONCLUSION: Itraconazole, given either topically or systemically, is effective in treating mycotic corneal ulcers.