Madduri Bhagyasree, Mohan Nitin, Fernandez Merle, Joseph Joveeta
Ocular Microbiology Services, L. V. Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India.
Shantilal Shanghvi Cornea Institute, L. V. Prasad Eye Institute, Hyderabad, Telangana, India.
Oman J Ophthalmol. 2024 Oct 24;17(3):352-356. doi: 10.4103/ojo.ojo_18_24. eCollection 2024 Sep-Dec.
Microbial keratitis is a potentially vision-threatening emergency that demands prompt diagnosis and treatment to ensure better vision recovery. Empirical use of broad-spectrum antimicrobial therapies is often the primary treatment modality, which is then tailored according to clinical response, cultured organisms, and their sensitivities. Since the spectrum of microbial agents associated with corneal ulcers is wide and varies from one geographical location to another, it is imperative that local microbial trends and susceptibility patterns are analyzed to enable better care in the management of these patients.
The aim of the study was to report the microbiological profile and drug susceptibility patterns of bacterial isolates obtained from patients with microbial keratitis in a single tertiary center in Andhra Pradesh over 12 years.
Microbiology records of culture-positive microbial keratitis that underwent a diagnostic corneal scraping and cultures from the years 2010 to 2021 were reviewed. Trends in bacterial and fungal etiology along with the antibiotic susceptibility profile of bacteria were analyzed.
Frequency distribution was obtained, and percentages were calculated.
Of the 8529 microbial keratitis samples, 3581 corneal scrapings were culture positive which included Gram-positive bacteria (1054/3581, 29.4%), Gram-negative bacteria (476/3581, 13.2%), fungi (2051/3581, 57.2%), and parasites (369/3581, 10.3%). The most common fungal isolate was species (557/1748, 31.8%) followed by (495/1748, 28.3%). Similarly, the most common Gram-positive bacteria included (297/891, 33.3%) and species (213/891, 23.9%), and the most common Gram-negative bacteria was (294/403, 72.9%). Overall susceptibility patterns showed that Gram-positive bacteria were susceptible to vancomycin (92%), cefazolin (88%), and chloramphenicol (86%), while Gram-negative bacteria were most susceptible to gentamicin and amikacin (81%). The susceptibility to amikacin and gentamicin increased significantly from 71% in 2010 to 92% in 2021 and 74% in 2010 to 92% in 2021, respectively. In comparison, the susceptibility of fluoroquinolones for both Gram-positive and Gram-negative bacteria did not show any significant change over the study period.
The prevalence of fungal and bacterial keratitis has remained unchanged over the years. This study reinforced that fluoroquinolones and vancomycin continue to be good empiric therapies for treating bacterial keratitis in Andhra Pradesh.
微生物性角膜炎是一种可能威胁视力的急症，需要及时诊断和治疗以确保更好的视力恢复。经验性使用广谱抗菌疗法通常是主要的治疗方式，随后根据临床反应、培养出的微生物及其敏感性进行调整。由于与角膜溃疡相关的微生物种类繁多，且因地理位置而异，因此分析当地的微生物趋势和药敏模式对于更好地管理这些患者至关重要。
本研究的目的是报告在安得拉邦一个单一的三级中心，12年间从微生物性角膜炎患者中分离出的细菌的微生物学特征和药敏模式。
回顾了2010年至2021年期间进行诊断性角膜刮片和培养的培养阳性微生物性角膜炎的微生物学记录。分析了细菌和真菌病因的趋势以及细菌的抗生素敏感性概况。
获得频率分布并计算百分比。
在8529份微生物性角膜炎样本中，3581份角膜刮片培养阳性，其中包括革兰氏阳性菌（1054/3581，29.4%）、革兰氏阴性菌（476/3581，13.2%）、真菌（2051/3581，57.2%）和寄生虫（369/3581，10.3%）。最常见的真菌分离株是 种（557/1748，31.8%），其次是 （495/1748，28.3%）。同样，最常见的革兰氏阳性菌包括 （297/891，33.3%）和 种（213/891，23.9%），最常见的革兰氏阴性菌是 （294/403，72.9%）。总体药敏模式显示，革兰氏阳性菌对万古霉素（92%）、头孢唑林（88%）和氯霉素（86%）敏感，而革兰氏阴性菌对庆大霉素和阿米卡星最敏感（81%）。对阿米卡星和庆大霉素的敏感性分别从2010年的71%显著增加到2021年的92%和从2010年的74%增加到2021年的92%。相比之下，在研究期间，氟喹诺酮类药物对革兰氏阳性菌和革兰氏阴性菌的敏感性均未显示出任何显著变化。
多年来真菌性和细菌性角膜炎的患病率保持不变。本研究强化了氟喹诺酮类药物和万古霉素仍然是治疗安得拉邦细菌性角膜炎的良好经验性疗法。
