2002
Ocular Microbiology and Immunology Group, Abstract 16
OMIG
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Comparison
of Clinico-Microbiological Features in Smear Positive and Smear
Negative cases of Microbial Keratitis.
Savitri Sharma, Mukesh Taneja, Anjall Upponi, Prashant Garg, Usha
Gopinathan, Nibaran Gangopadhyay, Rishitha Nutheti. LV Prasad Eye
Institute, Hyderabad, lndia
Purpose:
To compare culture results, clinical profile, and treatment outcome
in two groups of suspected microbial keratitis patients, 1) corneal
scraping smears positive, 2) corneal scraping smears negative; for
bacteria, fungus, Acanthamoeba, or herpes simplex virus.
Methods:
A prospective, non-randomized, comparative analsys (Fisher's exact
test) of all patients seen with suspected microbial keratitis between
31st Dec 2001 and 1st March 2002 was done. All patients had undergone
institutional protocol of slit lamp examination, corneal scrapings
for microbiological evaluation, and standard treatment. The data
was captured in the corneal ulcer database of the institute and
analyzed.
Results:
Out of 170 patients seen during this period 102(60%) were smear
positive and 68(40%) were smear negative. Culture was sterile in
significantly more number of patients with negative smears (57.3%
vs 17.6%, p<0.05). There was no difference in frequency of isolation
of gram positive and gram negative organisms in the two groups except
Streptococcus pneumoniae (grown more in smear positive group), indicating
over all low sensitivity of Gram stain. However, more fungi and
Acanthamoeba were isolated in smear positive group, pointing that
these are unlikely to be missed in smears. Smears were negative
in significantly more number of patients with corneal infiltrate
<25mm2 size (79.3% vs 49,0%, p<0.05). Although the severity
of infection was more in smear positive cases the resolution of
ulcer was also higher in this group indicating efficacy of specific
treatment.
Conclusions:
Initial smear examination results have significant influence on
therapy and outcome of microbial keratitis.
OMIG
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