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1.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(1): 16-24, abr. 2019. tab
Article in Spanish | LILACS, BDNPAR | ID: biblio-1007865

ABSTRACT

Las úlceras corneales de origen infeccioso son una emergencia oftalmológica que amenaza la visión y la integridad estructural del ojo, causando ceguera en 1,5 a 2 millones de casos al año por lo que requiere tratamiento inmediato. El objetivo fue determinar el patrón epidemiológico, factores de riesgo y efectividad del tratamiento en pacientes con úlcera corneal en la Fundación Visión en el periodo 2015-2017. Estudio de cohorte prospectivo donde se evaluó 53 pacientes con úlcera corneal de causa infecciosa que consultaron en la Fundación Visión en el periodo 2015-2017, y tuvieron un seguimiento mínimo de 4 meses. Se encontró un predominio del sexo masculino (69,8%), edad 45-65 años (49,1%), casados (54,7%), de condición socioeconómica baja (56,6%), agricultores (26,4%), con antecedente de traumatismo corneal (69,8%) o uso de lentes de contacto (17%). El agente etiológico fue bacteriano en el 49,1% y micótico en el 37,7%; para los de origen bacteriano el tratamiento más empleado fueron colirios fortificados de Cefazolina + Gentamicina y Natamicina/Fluconazol en caso de ser micótico. La evolución fue favorable en 90,9% y 80,0% de los bacterianos y micóticos, respectivamente. Los grupos de riesgo detectados fueron pacientes varones, agricultores, de condición socioeconómica baja, con antecedente de traumatismo corneal o uso de lentes de contacto. La efectividad del tratamiento utilizado fue mayor al 80%, siendo en su mayoría patógenos bacterianos(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Corneal Ulcer/drug therapy , Corneal Ulcer/epidemiology , Gentamicins/therapeutic use , Visual Acuity , Fluconazole/therapeutic use , Cefazolin/therapeutic use , Corneal Ulcer/microbiology , Natamycin/therapeutic use , Prospective Studies , Risk Factors , Treatment Outcome , Keratitis/complications , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use
2.
Arq. bras. oftalmol ; 82(1): 2-5, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-973875

ABSTRACT

ABSTRACT Purpose: To determine whether a correlation exists between pathogenic species and clinical findings, disease severity, and visual outcome in patients with keratitis and fungal growth in microbiological culture. Methods: A retrospective study of patients with fungal growth in the microbiological culture of corneal scrapings. Patients were treated at an ophthalmologic reference center in Southeastern Brazil from January 1992 to October 2015. Results: Medical records of 181 patients (131 males and 50 females) with a mean age of 47 ± 18 years were analyzed. The three most common etiologies were Fusarium sp. (38.7%), Aspergillus sp. (15%), and Candida sp. (13.2%). Among these, Fusarium sp. was the most frequent in patients aged £50 years (p=0.002) and in those with a recent history of a foreign body and/or ocular trauma (p=0.01). Candida sp. was the most frequent etiology in patients aged >50 years (p=0.002), in those with postoperative ocular surgery (p=0.002); in those with a previous ocular pathology (p=0.0007); and in immunodepressed patients (p=0.0004). Conclusion: Fusarium sp. was predominant in patients aged £50 years and those with a recent history of foreign body and/or ocular trauma, whereas Candida sp. was predominant in older adults, in those with a postoperative ocular surgery, in those with a previous ocular pathology, and in immunodepressed patients.


RESUMO Objetivo: Determinar se existe uma correlação entre espécies patogênicas e achados clínicos, gravidade da doença e resultado visual em pacientes com ceratite e crescimento de fungos em cultura microbiológica. Métodos: Estudo retrospectivo de pacientes com crescimento de fungos na cultura microbiológica de raspado de córnea. Os pacientes foram tratados em um centro de referência oftalmológica no Sudeste do Brasil de janeiro de 1992 a outubro de 2015. Resultados: Foram analisados registros médicos de 181 pacientes (131 homens e 50 mulheres) com idade média de 47 ± 18 anos. As três etiologias mais comuns foram Fusarium sp. (38,7%), Aspergillus sp. (15%) e Candida sp. (13,2%). Entre estas, Fusarium sp. foi a mais frequente em pacientes com idade £50 anos (p=0,002) e naqueles com história recente de corpo estranho e/ou trauma ocular (p=0,01). Candida sp. foi a etiologia mais frequente em pacientes com idade >50 anos (p=0,002), naqueles com cirurgia ocular pós-operatória (p=0,002); naqueles com patologia ocular prévia (p=0,0007); e em pacientes imunodeprimidos (p=0,0004). Conclusão: Fusarium sp. foi predominante em pacientes com idade £50 anos e naqueles com história recente de corpo estranho e/ou trauma ocular; enquanto Candida sp. foi predominante em adultos mais velhos, naqueles com cirurgia ocular pós-operatória, naqueles com patologia ocular prévia e em pacientes imunodeprimidos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Eye Infections, Fungal/microbiology , Eye Infections, Fungal/pathology , Corneal Ulcer/microbiology , Corneal Ulcer/pathology , Aspergillus/pathogenicity , Severity of Illness Index , Candida/pathogenicity , Visual Acuity , Eye Infections, Fungal/drug therapy , Corneal Ulcer/drug therapy , Eye Foreign Bodies/microbiology , Eye Foreign Bodies/pathology , Retrospective Studies , Risk Factors , Corneal Injuries/microbiology , Corneal Injuries/pathology , Fusarium/pathogenicity , Antifungal Agents/therapeutic use
3.
Arq. bras. oftalmol ; 79(4): 261-263, July-Aug. 2016. graf
Article in English | LILACS | ID: lil-794591

ABSTRACT

ABSTRACT Conjunctival ulceration accompanied with secretion and pain was observed in a 30-year-old male, 3 days after a perforating corneal trauma. Cultures of conjunctival ulcer samples grew Fonsecaea pedrosoi, a major causative agent of chromoblastomycosis that is typically transmitted during trauma. The conjunctival ulcer was successfully treated with amphotericin B, itraconazole, and fluconazole. This case report summarizes the diagnosis and treatment of a conjunctival ulcer due to F. pedrosoi, which is a rare complication of contaminated ocular trauma. To the best of our knowledge, this is the first reported case of F. pedrosoi causing acute conjunctival ulceration in the literature.


RESUMO O quadro clínico de uma úlcera conjuntival acompanhada de secreção e dor foi observado em homem de 30 anos de idade, 3 dias após um trauma perfurante da córnea. As culturas de uma amostra retirada da úlcera conjuntival foi positiva para Fonsecaea pedrosoi, uma cromoblastomicose, geralmente transmitido após traumatismos. O caso foi tratado com sucesso com a anfotericina B, itraconazol e fluconazol. Este relato de caso reporta o diagnóstico e tratamento de uma úlcera conjuntival causada por F. pedrosoi, que raramente é visto nos olhos expostos a traumatismos contaminados. Até onde sabemos, este é o primeiro caso relatado na literatura de F. pedrosoi causando úlcera conjuntival aguda.


Subject(s)
Humans , Male , Adult , Ascomycota/pathogenicity , Corneal Ulcer/microbiology , Chromoblastomycosis/microbiology , Conjunctival Diseases/microbiology , Corneal Perforation/microbiology , Ascomycota/isolation & purification , Corneal Ulcer/therapy , Chromoblastomycosis/therapy , Treatment Outcome , Conjunctival Diseases/therapy , Cornea/microbiology , Corneal Perforation/complications , Corneal Perforation/therapy , Antifungal Agents/therapeutic use
4.
Rev. bras. oftalmol ; 74(2): 76-80, Mar-Apr/2015. tab, graf
Article in Portuguese | LILACS | ID: lil-744621

ABSTRACT

Purpose: To identify the major etiological agents of UC in the main referral center for this disease in the state of Espírito Santo (Hospital Universitario Cassiano Antonio de Moraes – HUCAM). Methods: This is a retrospective study of UC cases that underwent microbiological analysis from january 2009 to june 2013 at HUCAM. Results: Three hundred ninety-eight cases were studied. Microbiological cultures were positive in 60% and negative in 40% of cases. The Gram stain was positive in 28%, negative in 61% and was not performed in 11%.Among the total number of tests, 16.3% were classified as insufficient material for analysis.The microbiological examination, including gram stain and culture, was positive in 250 tests (62.8%). It was identified bacteria in 48%, fungi in 17.6% and protozoa in 0,8% of cases. Conclusions: The study identified the main etiological agents involved in the UC at HUCAM. Hence, it provides data that can help physicians to do a better presumptive diagnosis and a more appropirate initial empirical treatment when indicated. Gram positive bacteria and filamentous fungi have a prominent role in the etiology of UC in ES.


Objetivo: Identificar os principais agentes etiológicos das úlceras de córnea atendidas no principal centro de referência para esta moléstia no estado do Espírito Santo (Hospital Universitário Cassiano Antônio de Moraes – HUCAM). Métodos: Estudo retrospectivo de prontuários, identificados por meio dos registros do laboratório de microbiologia do HUCAM, dos casos de úlcera de córnea submetidos à coleta de material para análise microbiológica no período de janeiro de 2009 a junho de 2013. Resultados: Dos 398 casos foram estudados e o resultado da cultura foi positivo em 60% e negativo em 40% dos casos. A bacterioscopia foi positiva em 28%, negativa em 61% e não foi realizada em 11%. Dentre o total de exames, 16,3% foram classificados como material insuficiente para análise. O exame microbiológico, incluindo bacterioscopia e cultura, foi positivo em 250 exames (62,8%), sendo identificado bactérias em 48% dos casos, fungos em 17,6% e protozoários em 0,8%. Conclusão: Este trabalho identificou os principais agentes etiológicos envolvidos na UC atendidas no HUCAM. Desta forma, fornecemos subsídios para um melhor o diagnóstico presuntivo e condução mais apropriada do tratamento empírico inicial, quando indicado. As bactérias Gram-positivas e fungos filamentosos apresentam papel de destaque na etiologia das UC no ES.


Subject(s)
Humans , Male , Female , Hospitals, University , Medical Records , Corneal Ulcer/epidemiology , Corneal Ulcer/etiology , Corneal Ulcer/microbiology , Brazil , Retrospective Studies
5.
Biomédica (Bogotá) ; 34(supl.1): 23-33, abr. 2014. tab
Article in Spanish | LILACS | ID: lil-712418

ABSTRACT

Introducción. La resistencia bacteriana es crítica para la selección de los antibióticos en el tratamiento de las infecciones, por ello es vital conocer su estado actual en nuestro medio. Objetivo. Determinar la sensibilidad antibiótica bacteriana in vitro obtenida de los cultivos de queratitis e infecciones intraoculares. Materiales y métodos. Se llevó a cabo un estudio retrospectivo en la Fundación Oftalmológica de Santander (FOSCAL), entre junio de 2011 y enero de 2012. Resultados. Se examinaron 92 muestras. Se identificaron 110 bacterias, 27 hongos y 12 amebas de vida libre. Del total de bacterias Gram positivas, 1,1 %, 0 %, 1,1 %, 16,9 %, 29,3 % y 85 % fue resistente a imipenem, moxifloxacina, gatifloxacina, levofloxacina, ciprofloxacina y tobramicina, respectivamente, mientras que la resistencia a estos mismos fármacos se presentó, respectivamente, en 0 %, 8,3 %, 0 %, 0 %, 18,2 % y 27,3 % de las bacterias Gram negativas. Los porcentajes de resistencia de los estafilococos positivos para coagulasa resistentes a la meticilina fueron 0 %, 0 %, 0 %, 7 %, 17 % y 100 %, respectivamente, y los porcentajes de los estafilococos negativos para coagulasa resistentes a la meticilina fueron 3 %, 0 %, 0 %, 24 %, 44 % y 100 %, respectivamente. Los porcentajes de resistencia bacteriana globales (tanto para bacterias Gram positivas como para Gram negativas) a imipenem, moxifloxacina, gatifloxacina, levofloxacina, ciprofloxacina y tobramicina fueron 1 %, 1 %, 1 %, 15,1 %, 28 % y 64,5 %, respectivamente. Conclusiones. Los niveles de resistencia bacteriana para imipenem, moxifloxacina y gatifloxacina fueron menores que para levofloxacina, ciprofloxacina y tobramicina. Los niveles de resistencia para la tobramicina fueron muy altos, lo que pone en duda su utilidad clínica en las infecciones oculares en nuestro medio.


Introduction: Bacterial resistance is critical for the selection of antibiotics in the treatment of infections, so it is vital to know its current status in our geographical area. Objective: To determine in vitro antibiotic susceptibility of bacterial isolates obtained from keratitis and intraocular infections. Materials and methods: A retrospective study of microbiological tests in Fundación Oftalmológica de Santander (FOSCAL) was carried out between June, 2011, and January, 2012. Results: A total of 92 samples were examined and 110 bacteria, 27 fungi and 12 free-living amoebae were identified. Polymicrobial infections constituted 50% of the total; 1.1%, 0%, 1.1%, 16.9%, 29.3% and 85% of Gram-positive bacteria were resistant to imipenem, moxifloxacin, gatifloxacin, levofloxacin, ciprofloxacin and tobramycin, respectively, while 0%, 8.3%, 0%, 0%, 18.2% and 27.3% of Gram-negative bacteria were resistant to imipenem, moxifloxacin, gatifloxacin, levofloxacin, ciprofloxacin and tobramycin, respectively. For methicillin-resistant coagulase-positive staphylococci, resistance percentages to imipenem, moxifloxacin, gatifloxacin, levofloxacin, ciprofloxacin and tobramycin were 0%, 0%, 0%, 7%, 17% and 100%, respectively. For methicillin-resistant coagulase-negative staphylococci, resistance percentages to imipenem, moxifloxacin, gatifloxacin, levofloxacin, ciprofloxacin and tobramycin were 3%, 0%, 0%, 24%, 44% and 100%, respectively. Overall bacterial resistance to imipenem, moxifloxacin, gatifloxacin, levofloxacin, ciprofloxacin and tobramycin, for both Gram-positive and Gram-negative, was 1%, 1%, 1%, 15.1%, 28% and 64.5%, respectively. Conclusions: The levels of bacterial resistance to imipenem, moxifloxacin and gatifloxacin were lower than for levofloxacin, ciprofloxacin and tobramycin. The levels of resistance to tobramycin were very high, which calls into question its usefulness in this region of our country.


Subject(s)
Humans , Corneal Ulcer/microbiology , Drug Resistance, Multiple, Bacterial , Endophthalmitis/microbiology , Eye Infections, Bacterial/microbiology , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Acanthamoeba Keratitis/epidemiology , Acanthamoeba Keratitis/microbiology , Acanthamoeba/isolation & purification , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/pharmacology , Aqueous Humor/microbiology , Colombia/epidemiology , Cornea/microbiology , Corneal Ulcer/drug therapy , Corneal Ulcer/epidemiology , Disk Diffusion Antimicrobial Tests , Endophthalmitis/drug therapy , Endophthalmitis/epidemiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/epidemiology , Eye Infections, Fungal/epidemiology , Eye Infections, Fungal/microbiology , Eye Infections, Parasitic/epidemiology , Eye Infections, Parasitic/parasitology , Foundations , Fluoroquinolones/pharmacology , Fungi/isolation & purification , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Retrospective Studies , Vitreous Body/microbiology
6.
Indian J Ophthalmol ; 2012 Jul-Aug; 60(4): 267-272
Article in English | IMSEAR | ID: sea-144851

ABSTRACT

Context: Study of patients attending tertiary care ophthalmology institute at Ahmedabad. Aims: To study the microbiological etiology and epidemiological factors associated with suppurative keratitis. Settings and Design: A total of 150 corneal scrapings were evaluated from patients presenting with corneal ulcers at a tertiary ophthalmology center, Ahmedabad from July 2007 to June 2008. Materials and Methods: Scrapings were subjected to Gram stain, potassium hydroxide preparation and culture for bacterial and fungal pathogens. Socio-demographic data and risk factors were recorded. Results: Ninety percent (135/150) people with corneal ulcers had trauma as predisposing factor for keratitis. Trauma due to wooden objects was the leading cause (46/135) followed by vegetable matter and stone injury (23/135). Microbial etiology was established in 59.3% (89/150) of scrapings. Out of 89 positive isolates, 65.1% (58/89) were bacterial while 34.9% (31/89) were fungal. Among the bacterial isolates, 60.3% (35/58) were Gram-positive cocci while 39.7% (23/58) were Gram-negative bacilli. The most common bacterial isolate was Staphylococus aureus (32.7%, 19/58) followed by coagulase-negative Staphylococci (25.8%, 15/58) and Pseudomonas (18.9%, 11/58). Among the 31 fungal pathogens, Aspergillus species was the most common (35.4%11/31), followed by Fusarium species (22.5%, 7/31). Conclusion: Trauma with wooden material is the most common predisposing factor for suppurative keratitis. Males were more affected than females. Bacterial ulcers were more common than fungal in areas in and around Ahmedabad. Staphylococcus aureus and Aspergillus were the commonest bacterial and fungal isolates respectively. Geographical variation persists in microbial etiology of suppurative keratitis.


Subject(s)
Corneal Ulcer/epidemiology , Corneal Ulcer/etiology , Corneal Ulcer/microbiology , Eye Infections, Bacterial/epidemiology , Eye Infections, Bacterial/etiology , Eye Infections, Bacterial/microbiology , Eye Injuries/epidemiology , Eye Injuries/etiology , Eye Injuries/microbiology , Humans , India/epidemiology , Keratitis/epidemiology , Keratitis/etiology , Keratitis/microbiology , Pseudomonas Infections/epidemiology , Pseudomonas Infections/etiology , Pseudomonas Infections/microbiology , Staphylococcal Infections/epidemiology , Staphylococcal Infections/etiology , Staphylococcal Infections/microbiology
7.
Indian J Ophthalmol ; 2011 Sept; 59(5): 367-371
Article in English | IMSEAR | ID: sea-136207

ABSTRACT

Purpose: To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam. Materials and Methods: In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire. Results: In 188 (60.6%) cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%). The maximum (23.4%) cases were reported during the paddy harvesting season in Assam (January and February). Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH) mount. The commonest predisposing factor was corneal injury (74.5%). While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25%) was the commonest isolate followed by Aspergillus species (19%), Curvularia species (18.5%) and Penicillium species (15.2%). Yeasts were isolated in 2.7% (n=5) cases. Conclusions: Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.


Subject(s)
Adolescent , Adult , Cornea/microbiology , Corneal Ulcer/diagnosis , Corneal Ulcer/epidemiology , Corneal Ulcer/microbiology , Eye Infections, Fungal/diagnosis , Eye Infections, Fungal/epidemiology , Eye Infections, Fungal/microbiology , Female , Fungi/isolation & purification , Humans , Incidence , India/epidemiology , Male , Mycoses/diagnosis , Mycoses/epidemiology , Mycoses/microbiology , Prognosis , Prospective Studies , Retrospective Studies , Risk Factors
8.
Indian J Ophthalmol ; 2011 July; 59(4): 291-296
Article in English | IMSEAR | ID: sea-136192

ABSTRACT

Purpose: To determine the incidence, outcomes and establish factors determining visual prognosis of keratomycosis due to pigmented fungi in comparison with nonpigmented fungi. Materials and Methods: All culture-proven cases of fungal keratitis from January 2006 to August 2008 were drawn from a computerized database and cases with adequate documentation were analyzed for predisposing factors, clinical characteristics, microbiology and treatment methods. Outcomes of keratitis due to pigmented and nonpigmented fungi were compared using t-test and χ2 test. Results: Of 373 cases of keratomycosis during the study period, pigmented fungi were etiological agents in 117 eyes (31.3%) and nonpigmented fungi in 256 eyes (68.7%). Eyes with nonpigmented keratitis had significantly larger ulcers (14.96 mm2 ) and poorer vision (1.42 logMAR) at presentation compared to those with keratomycosis due to pigmented fungi (P=0.01). The characteristic macroscopic pigmentation was seen in only 14.5% in the pigmented keratitis group. Both groups responded favorably to medical therapy (78.1% vs. 69.1%) with scar formation (P=0.32) and showed a significant improvement in mean visual acuity compared with that at presentation (P<0.01). Visual improvement in terms of line gainers and losers in the subgroup of eyes that experienced healing was also similar. Location of the ulcer was the only factor that had significant predictive value for visual outcome (P=0.021). Conclusion: Incidence of keratomycosis due to pigmented fungi may be increasing as compared to previous data. These eyes have similar response to medical therapy and similar visual outcome compared to nonpigmented keratitis. Central ulcers have a poor visual outcome.


Subject(s)
Adult , Antifungal Agents/therapeutic use , Cicatrix/etiology , Corneal Ulcer/microbiology , Databases, Factual , Eye Infections, Fungal/drug therapy , Female , Fungi/physiology , Humans , Incidence , Keratitis/complications , Keratitis/epidemiology , Keratitis/microbiology , Keratitis/physiopathology , Male , Middle Aged , Pigmentation , Prognosis , Visual Acuity/drug effects , Wound Healing
12.
Indian J Ophthalmol ; 2010 Sept; 58(5): 415-417
Article in English | IMSEAR | ID: sea-136098

ABSTRACT

Colletotrichum graminicola is a medically important fungus belonging to the order Melanconiales under the class Coelomycetes. The members of the genus Colletotrichum are primarily plant pathogens which cause anthracnoses (fungal infection in plants). In the past few decades, they are progressively being implicated as etiological agents of subcutaneous hyalohyphomycoses and keratomycoses. Of the five medically important members in the genus Colletotrichum, keratitis due to Colletotrichum graminicola is rare. We diagnosed Colletotrichum graminicola keratitis in a 44-year-old man who presented with a non-healing corneal ulcer since three weeks. Positive smears and cultures from the corneal scrapings established the causative organism as C. graminicola. The patient was treated with a combination of oral ketoconazole and topical fluconazole and natamycin. Infection resolved over 10 weeks and antimicrobials were stopped. We describe the clinical presentation and treatment outcome of Colletotrichum graminicola keratitis.


Subject(s)
Administration, Oral , Adult , Antifungal Agents/administration & dosage , Colletotrichum , Corneal Ulcer/microbiology , Drug Therapy, Combination , Fluconazole/administration & dosage , Humans , Keratitis/diagnosis , Keratitis/microbiology , Ketoconazole/administration & dosage , Male , Mycoses/diagnosis , Mycoses/drug therapy , Natamycin/administration & dosage , Treatment Outcome
13.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2010; 20 (9): 604-607
in English | IMEMR | ID: emr-97644

ABSTRACT

To identify the different microbial pathogens in infective corneal ulcers. Observational study. Department of Ophthalmology Unit I, Eye Hospital, Liaquat University of Medical and Health Sciences, Hyderabad, Sindh, from April 2006 to September 2008. Patients above 15 years of age with suspected infective corneal ulcers were studied. After detailed history every patient underwent a comprehensive ophthalmic slit lamp bio-microscopical examination, for characteristics of the ulcer to locate the site, size, depth of ulcer and anterior chamber inflammation. After a detailed ocular examination corneal scrapings were collected under aseptic conditions under magnification of slit lamp or operating microscope. The scraping material obtained from leading edge and base of each ulcer was spread onto labeled slides for staining. Another portion was inoculated on to the surface of solid and the liquid culture medias. The inoculated medias were incubated at appropriate temperature for appropriate time. Of the 328 patients; 192 [64.99%] were male with age ranging from 15 to 80 years, and majority from rural population [64.99%]. Majority i.e. 201 [61.28%] were previously treated. Out of 328 patients, 161 cultured [49.10%] for bacteria, 87 [26.52%] for fungi, and 12 were found positive culture for both bacteria and fungi. The rest of 68 [20.73%] were culture-negative corneal ulcers. Of the 173 bacterial isolates, 119 [68.79%] had Gram positive cocci, most common isolated being Staphylococcus aureus in 82 [47.40%]; fungal pathogens were isolated from 99 corneal ulcers. The commonest organism isolated was Candida albicans in 75.76%, followed by Aspergillus flavus in 11.11% of the total fungal isolates. Staphylococcus aureus, Candida albicans and Aspergillus flavus were common causes of microbial infective keratitis in this series


Subject(s)
Humans , Male , Female , Aged , Adolescent , Adult , Middle Aged , Corneal Ulcer/microbiology , Staphylococcus aureus , Candida albicans , Keratitis/etiology , Keratitis/diagnosis
14.
Rev. chil. infectol ; 25(4): 295-300, ago. 2008. ilus
Article in Spanish | LILACS | ID: lil-490649

ABSTRACT

We report the case of a female patient, 56-year-old housewife, for the first time user of last generation contact lenses: Lotrafilcon B, which presented a severe corneal ulcer by Pseudomonas aeruginosa in hev left eye and subsequently required keratoplasty. Initially she reported pain and arrived at the emergency department with red eye, corneal central ulcer of three days of evolution and hypopion. Initially she received topic mydriatic drugs and prednisolone at 1 percent. At the next day the ophthalmologycal exam showed hypopion at 5 percent and a central severe ulcer greater than 3 mm in diameter with sharp edges and mucopurulent secretion. The treatment was changed to moxifloxacin and natamycin. The microbiological analysis performed in two laboratories yielded Aspergillus sp. and Pseudomonas aeruginosa sensitive to ciprofloxacin, tobramycin, gentamicin and moxifloxacin. The presence of Aspergillus was interpreted as a pollution lens case and likely colonization of the cornea because of the patient good performance. After four months although improving she required corneal transplantation. Photographic documentation of the case under illumination with slit lamp is presented.


Se comunica el caso de una paciente mujer, de 56 años de edad, ama de casa, usuaria por primera vez de lentes de contacto de última generación: lotrafilcon B, que presentó una úlcera corneal grave por Pseudomonas aeruginosa en su ojo izquierdo y posteriormente requirió quera toplastía. Inicialmente reportó dolor y llegó a la unidad de urgencia con ojo rojo, úlcera corneal central de tres días de evolución e hipopión. El tratamiento farmacológico inicial fue con midriático y prednisolona al 1 por ciento. La valoración oftalmológica del día siguiente demostró hipopión al 5 por ciento y úlcera central grave mayor a 3 mm de diámetro con bordes definidos y secreción mucopurulenta. Se cambió tratamiento a moxifloxacina y natamicina. El análisis microbiológico en dos laboratorios, confirmó el aislado de Aspergillus sp y Pseudomonas aeruginosa; esta última sensible a ciprofloxacina, tobramicina, gentamicina y moxifloxacina. La presencia de Aspergillus se interpretó como contaminación del estuche y probable colonización de la cornea por la clínica y buena evolución. A los cuatro meses de evolución, aunque presentó mejoría, requirió trasplante corneal. Se incluye documentación fotográfica del caso bajo iluminación con lámpara de hendidura.


Subject(s)
Female , Humans , Middle Aged , Contact Lenses, Extended-Wear/adverse effects , Corneal Ulcer/microbiology , Pseudomonas Infections/complications , Corneal Transplantation , Contact Lenses, Extended-Wear/microbiology , Corneal Ulcer/surgery , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/isolation & purification
15.
Indian J Pathol Microbiol ; 2008 Apr-Jun; 51(2): 304-6
Article in English | IMSEAR | ID: sea-73656

ABSTRACT

To find out the prevalence and epidemiological features of keratomycosis in Chandigarh, the present study was carried out jointly by the Departments of Microbiology and Ophthalmology, Government Medical College Hospital, Chandigarh, over a period of 5 years from January 1999 to December 2003. Corneal scrapings were collected from a total of 154 suspected patients of keratomycosis and were processed and identified by standard laboratory techniques. The study revealed that a total of 64 cases (41.55%) were positive for fungal agents. Direct microscopy was positive in 52 cases (76.47%) and culture in 34 cases (53.12%). Most common fungal isolates were Aspergillus species 14 (41.18%), Fusarium species 8 (23.53%), Candida species 3 (8.82%), Curvularia species 2 (5.88%) and Bipolaris species 2 (5.88%). Thus, hyaline filamentous fungi were the most common etiological agents and mechanical trauma with vegetative matter was the most common predisposing factor. Males in age group of 21-50 years were more commonly affected.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Aspergillus/isolation & purification , Candida/isolation & purification , Corneal Ulcer/microbiology , Eye Infections, Fungal/epidemiology , Female , Fusarium/isolation & purification , Humans , India/epidemiology , Keratitis/epidemiology , Male , Middle Aged
16.
Indian J Ophthalmol ; 2007 Jan-Feb; 55(1): 9-13
Article in English | IMSEAR | ID: sea-71156

ABSTRACT

BACKGROUND: Staphylococcus epidermidis, a commensal of the conjunctival sac has been incriminated as the commonest etiological agent of bacterial keratitis. However, the pathogenic potential of this commensal organism is not clearly known. AIM: To determine any phenotypic, molecular markers of S. epidermidis pathogenicity in bacterial keratitis. MATERIALS AND METHODS: A total of 382 corneal ulcer isolates of S. epidermidis and 87 S. epidermidis isolates from healthy eyes (controls) were studied. Speciation, biotyping and antibiotic sensitivity testing were performed by conventional methods. Tube slime and adherence tests were carried out by recommended techniques. Plasmid analysis was conducted by a standard protocol. STATISTICAL ANALYSIS: Chi-square test was employed for calculations. RESULTS: Out of 382 corneal ulcer isolates (Pathogens) 284 (74.3%) belonged to biotypes I and II. Slime was detected in 164 (42.9%) of 382 pathogens vs. 21 (24.1%) of 87 controls (P<0.001). Sixty-five (39.6%) of 164 slime positive isolates were multidrug-resistant as compared to only 49 (22.4%) of 218 slime negative isolates (P<0.001). A significantly higher number i.e, 73.1% (120/164) of slime-producers possessed a 21 Kb plasmid in contrast to only 53.2% (116/218) of nonslime-producers (P<0.001). Presence of this plasmid had a statistical correlation of low significance with multidrug resistance (P=0.04). One hundred and seventy-two (45.0%) of 382 pathogens and 24 (27.6%) of the 87 controls were adherent to artificial surfaces (P=0.003) and the majority of the adherent organisms (99/172, 57.6%) were slime producers (P<0.001). CONCLUSIONS: Slime was associated with multidrug resistance in corneal ulcer isolates of S. epidermidis. The 21 Kb plasmid could determine virulence as it was responsible for slime production and adherence.


Subject(s)
Corneal Ulcer/microbiology , Drug Resistance, Multiple, Bacterial , Humans , Keratitis/microbiology , Phenotype , Plasmids , Staphylococcal Infections/microbiology , Staphylococcus epidermidis/genetics
17.
Arq. bras. med. vet. zootec ; 58(6): 1024-1029, dez. 2006. ilus, tab
Article in English | LILACS | ID: lil-455044

ABSTRACT

A total of 22 clinical specimens were obtained from 19 dogs with corneal ulcer (16 unilateral and three bilateral) for isolation and antimicrobial susceptibility evaluation of the isolated bacteria. Bacterial growth was observed in 100 percent of the samples (n=22). Staphylococcus intermedius was the predominant species (35.5 percent), followed by Corynebacterium xerosis (19.3 percent). Gentamicin, ciprofloxacin, chloramphenicol and tobramycin had a high efficacy against all of the isolated bacteria. The results evidenced that 80.7 percent of the isolates were Gram positive cocci and Gram positive bacilli, and that those microorganisms were sensitive to gentamicin, ciprofloxacin, chloramphenicol and tobramycin.


Utilizaram-se 22 amostras de material, obtidas de 19 cães com úlcera de córnea, sendo 16 unilaterais e três bilaterais, para isolamento e avaliação da susceptibilidade antimicrobiana das bactérias isoladas. Observou-se crescimento bacteriano em 100 por cento das amostras (n=22). A espécie predominante foi Staphylococcus intermedius (35,5 por cento) seguido de Corynebacterium xerosis (19,3 por cento). Gentamicina, ciprofloxacina, cloranfenicol e tobramicina apresentaram alta eficácia contra todas as bactérias isoladas. Os resultados evidenciam que 80,7 por cento dos isolados foram cocos e bacilos Gram positivos e que estes microrganismos foram sensíveis à gentamicina, ciprofloxacina, cloranfenicol e tobramicina.


Subject(s)
Animals , Chloramphenicol/administration & dosage , Corynebacterium/isolation & purification , Dogs , Gentamicins/administration & dosage , Staphylococcus/isolation & purification , Tobramycin/administration & dosage , Corneal Ulcer/microbiology
18.
Article in English | IMSEAR | ID: sea-25944

ABSTRACT

BACKGROUND & OBJECTIVE: Corneal blindness is a major health problem worldwide and infectious keratitis is one of the predominant causes. The incidence of fungal keratitis has increased over the last few years. Though a few studies have been carried out on mycotic keratitis from north and other parts of India, there are none from Delhi. Keeping this in mind, this study was conducted to evaluate the frequency of positive fungal cultures in infectious keratitis and of the various fungal species identified as aetiologic agents in patients attending a tertiary care hospital in East Delhi. METHODS: Corneal scrapings from 346 patients of corneal ulcer with suspected fungal aetiology were subjected to direct examination by 10 per cent KOH mount, Gram stain and culture. The results were examined retrospectively and analyzed. RESULTS: Of the 346 patients of corneal ulcer investigated, in 77 (22.25%) cases fungal aetiology was identified. Males were more commonly affected and were mostly in the age group of 31-40 yr. It was seen that trauma was the most common predisposing factor especially in the agriculturists and the farmers. Aspergillus flavus was the most common fungus isolated in 31.16 per cent cases, followed by A. fumigatus (16.88%) and Fusarium spp. (7.79%). Yeasts were also isolated in 21.62 per cent cases. Both yeasts and mycelial fungi were isolated in 6.5 per cent of cases. INTERPRETATION & CONCLUSION: Because of serious consequences of infectious keratitis, it is important to know the exact aetiology of corneal ulcer to institute appropriate therapy in time. Laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing corticosteroids and antibacterial antibiotics.


Subject(s)
Adult , Corneal Ulcer/microbiology , Eye Infections, Fungal/microbiology , Female , Fungi/isolation & purification , Humans , Keratitis/microbiology , Male , Retrospective Studies
19.
Archives of Iranian Medicine. 2006; 9 (3): 222-227
in English | IMEMR | ID: emr-76111

ABSTRACT

Fungal keratitis is a suppurative, ulcerative, and sight-threatening infection of the cornea that sometimes leads to loss of the eye. The objectives of this study were to improve facilities for laboratory diagnosis, to determine the predominant causative microorganisms, and to identify the predisposing factors of mycotic keratitis patients. A prospective study of corneal ulcer was conducted in Sari between May 2004 and March 2005. Patients who presented with clinically suspected corneal ulcer to the Ophthalmology Department of Bou-Ali Sina University Hospital in Sari were included in this study. Each patient was examined with slit lamp. Data were collected by examining and questioning the patients. Using standard techniques, corneal scraping was performed by an ophthalmologist. The specimens collected were then smeared on two slides, which were stained with Gram stain [for bacterial keratitis] and 10% potassium hydroxide with or without Calcofluor white stain [for fungal keratitis], and studied under light microscope. The specimens were also inoculated directly on blood agar, Sabouraud dextrose agar, and potato dextrose agar in C-shaped streaks. A total of 22 patients met the inclusion criteria of this study, among whom 10 [45.5%] were females and 12 [54.5%] were males. The mean +/- SD age of patients was 61.5 +/- 17.7 [range: 15 - 83] years. In direct microscopy, branching, and septate hyphae were identified in 7 [31.8%] patients. Two [28.6%] fungi [Aspergillus fumigatus and Fusarium spp.] were isolated. Five [31.8%] patients with fungal keratitis were males and 2 [28.6%] were females. The mean +/- SD age of patients with fungal keratitis was 60.4 +/- 12.1 [range: 39 - 73] years. Three [42.85%] patients with fungal keratitis were farmers. The mean interval between the onset of symptom and diagnosis was 26.4 [range: 1 - 93] days. Trauma with plant debris and straws were noted in two [28.6%] patients with fungal keratitis. Five [71.4%] patients received topical antibiotics. Analyses, using potassium hydroxide with or without Calcofluor white as the gold-standard test, revealed a sensitivity of 71.4% for potassium hydroxide, and 42.9% for Gram stain. Infections of the cornea due to filamentous fungi are frequent causes of corneal damage and should always be kept in mind. The direct microscopy method is an essential tool in the diagnosis of fungal keratitis. Therefore, wet mount preparation with potassium hydroxide with or without Calcofluor white or only KOH can be relied upon as the single most important screening test for rapid diagnosis of fungal corneal ulcer


Subject(s)
Humans , Male , Female , Keratitis/microbiology , Corneal Ulcer/microbiology , Eye Infections, Fungal , Prospective Studies
20.
Arq. bras. oftalmol ; 68(6): 828-832, nov.-dez. 2005. tab, graf
Article in Portuguese | LILACS | ID: lil-420194

ABSTRACT

OBJETIVO: O objetivo do presente estudo é determinar os aspectos microbiológicos da ceratite infecciosa em crianças (0-18 anos) atendidas no Departamento de Oftalmologia do Hospital de Clínicas da Universidade Nacional de Assunção - Paraguai, em período de 14 anos (1988-2002). MÉTODOS: Estudo retrospectivo por análise de prontuários de 146 crianças cuja idade variou de 0 a 18 anos com úlceras de córnea de etiologia infecciosa, atendidas no Departamento de Oftalmologia do Hospital de Clínicas da Universidade Nacional de Assunção - Paraguai, no período compreendido entre março de 1988 a agosto de 2002. Todas as crianças foram submetidas a colheita de material da úlcera infecciosa e este foi encaminhado para análise microbiológica. RESULTADOS: As culturas foram positivas em 113 pacientes (77 por cento) e destas 78 (70 por cento) foram de etiologia bacteriana e 35 (30 por cento) foram de etiologia fúngica. Das bactérias isoladas, as principais foram: 18 (23,1 por cento) estafilococos coagulase-negativo, 15 (19,2 por cento) Staphylococcus aureus, 10 (12,8 por cento) Pseudomonas aeruginosa e 10 (12,8 por cento) Streptococcus pneumoniae. Foram isolados 35 fungos dos quais os principais foram: 9 (25 por cento) Acremonium ssp, seguidos de 5 (14 por cento) Fusarium ssp, 5 (14 por cento) Aspergillus fumigatus. CONCLUSÕES: A ceratite infecciosa em crianças atendidas em um Hospital Universitário (referência terciária) na cidade de Assunção - Paraguai é com maior freqüência bacteriana, com predomínio de gram-positivos.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Corneal Ulcer/microbiology , Gram-Positive Bacteria/isolation & purification , Mitosporic Fungi/isolation & purification , Age Distribution , Acremonium/isolation & purification , Anti-Bacterial Agents/therapeutic use , Colony Count, Microbial , Corneal Ulcer/drug therapy , Corneal Ulcer/epidemiology , Ophthalmic Solutions/therapeutic use , Paraguay/epidemiology , Retrospective Studies , Risk Factors , Rural Population , Sex Distribution , Staphylococcus/isolation & purification
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