Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India

AIMS/BACKGROUND To determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in Madurai, south India, and to identify the specific pathogenic organisms responsible for infection. METHODS All patients with suspected infectious central corneal ulceration present...

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Veröffentlicht in:British journal of ophthalmology 1997-11, Vol.81 (11), p.965-971
Hauptverfasser: Srinivasan, M, Gonzales, Christine A, George, Celine, Cevallos, Vicky, Mascarenhas, Jeena M, Asokan, B, Wilkins, John, Smolin, Gilbert, Whitcher, John P
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container_end_page 971
container_issue 11
container_start_page 965
container_title British journal of ophthalmology
container_volume 81
creator Srinivasan, M
Gonzales, Christine A
George, Celine
Cevallos, Vicky
Mascarenhas, Jeena M
Asokan, B
Wilkins, John
Smolin, Gilbert
Whitcher, John P
description AIMS/BACKGROUND To determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in Madurai, south India, and to identify the specific pathogenic organisms responsible for infection. METHODS All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service at Aravind Eye Hospital, Madurai, from 1 January to 31 March 1994 were evaluated. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. RESULTS In the 3 month period 434 patients with central corneal ulceration were evaluated. A history of previous corneal injury was present in 284 patients (65.4%). Cornea cultures were positive in 297 patients (68.4%). Of those individuals with positive cultures 140 (47.1%) had pure bacterial infections, 139 (46.8%) had pure fungal infections, 15 (5.1%) had mixed bacteria and fungi, and three (1.0%) grew pure cultures ofAcanthamoeba. The most common bacterial pathogen isolated was Streptococcus pneumoniae, representing 44.3% of all positive bacterial cultures, followed by Pseudomonas spp (14.4%). The most common fungal pathogen isolated was Fusariumspp, representing 47.1% of all positive fungal cultures, followed by Aspergillus spp (16.1%). CONCLUSIONS Central corneal ulceration is a common problem in south India and most often occurs after a superficial corneal injury with organic material. Bacterial and fungal infections occur in equal numbers with Streptococcus pneumoniaeaccounting for the majority of bacterial ulcers and Fusariumspp responsible for most of the fungal infections. These findings have important public health implications for the treatment and prevention of corneal ulceration in the developing world.
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METHODS All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service at Aravind Eye Hospital, Madurai, from 1 January to 31 March 1994 were evaluated. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. RESULTS In the 3 month period 434 patients with central corneal ulceration were evaluated. A history of previous corneal injury was present in 284 patients (65.4%). Cornea cultures were positive in 297 patients (68.4%). Of those individuals with positive cultures 140 (47.1%) had pure bacterial infections, 139 (46.8%) had pure fungal infections, 15 (5.1%) had mixed bacteria and fungi, and three (1.0%) grew pure cultures ofAcanthamoeba. The most common bacterial pathogen isolated was Streptococcus pneumoniae, representing 44.3% of all positive bacterial cultures, followed by Pseudomonas spp (14.4%). The most common fungal pathogen isolated was Fusariumspp, representing 47.1% of all positive fungal cultures, followed by Aspergillus spp (16.1%). CONCLUSIONS Central corneal ulceration is a common problem in south India and most often occurs after a superficial corneal injury with organic material. Bacterial and fungal infections occur in equal numbers with Streptococcus pneumoniaeaccounting for the majority of bacterial ulcers and Fusariumspp responsible for most of the fungal infections. These findings have important public health implications for the treatment and prevention of corneal ulceration in the developing world.</description><identifier>ISSN: 0007-1161</identifier><identifier>EISSN: 1468-2079</identifier><identifier>DOI: 10.1136/bjo.81.11.965</identifier><identifier>PMID: 9505820</identifier><identifier>CODEN: BJOPAL</identifier><language>eng</language><publisher>BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd</publisher><subject>Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Child ; Child, Preschool ; Corneal Ulcer - epidemiology ; Corneal Ulcer - etiology ; corneal ulceration ; developing world ; Diseases of cornea, anterior segment and sclera ; epidemiology ; Eye Infections, Bacterial - complications ; Eye Infections, Bacterial - epidemiology ; Eye Infections, Fungal - complications ; Eye Infections, Fungal - epidemiology ; Eye Injuries - complications ; Female ; Fusarium - isolation &amp; purification ; Humans ; India - epidemiology ; Infant ; Infant, Newborn ; Male ; Medical sciences ; microbial keratitis ; Middle Aged ; Ophthalmology ; Original articles - Clinical science ; Pseudomonas - isolation &amp; purification ; Pseudomonas Infections - complications ; Risk Factors ; Streptococcal Infections - complications ; Streptococcus pneumoniae - isolation &amp; purification ; Tropical medicine</subject><ispartof>British journal of ophthalmology, 1997-11, Vol.81 (11), p.965-971</ispartof><rights>British Journal of Ophthalmology</rights><rights>1998 INIST-CNRS</rights><rights>Copyright: 1997 British Journal of Ophthalmology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b576t-eb555d23bb751e21b6abd9d94610b9bc94514de1a9aa8d4a04688a33678757b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722056/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722056/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=2051594$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9505820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Srinivasan, M</creatorcontrib><creatorcontrib>Gonzales, Christine A</creatorcontrib><creatorcontrib>George, Celine</creatorcontrib><creatorcontrib>Cevallos, Vicky</creatorcontrib><creatorcontrib>Mascarenhas, Jeena M</creatorcontrib><creatorcontrib>Asokan, B</creatorcontrib><creatorcontrib>Wilkins, John</creatorcontrib><creatorcontrib>Smolin, Gilbert</creatorcontrib><creatorcontrib>Whitcher, John P</creatorcontrib><title>Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India</title><title>British journal of ophthalmology</title><addtitle>Br J Ophthalmol</addtitle><description>AIMS/BACKGROUND To determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in Madurai, south India, and to identify the specific pathogenic organisms responsible for infection. METHODS All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service at Aravind Eye Hospital, Madurai, from 1 January to 31 March 1994 were evaluated. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. RESULTS In the 3 month period 434 patients with central corneal ulceration were evaluated. A history of previous corneal injury was present in 284 patients (65.4%). Cornea cultures were positive in 297 patients (68.4%). Of those individuals with positive cultures 140 (47.1%) had pure bacterial infections, 139 (46.8%) had pure fungal infections, 15 (5.1%) had mixed bacteria and fungi, and three (1.0%) grew pure cultures ofAcanthamoeba. The most common bacterial pathogen isolated was Streptococcus pneumoniae, representing 44.3% of all positive bacterial cultures, followed by Pseudomonas spp (14.4%). The most common fungal pathogen isolated was Fusariumspp, representing 47.1% of all positive fungal cultures, followed by Aspergillus spp (16.1%). CONCLUSIONS Central corneal ulceration is a common problem in south India and most often occurs after a superficial corneal injury with organic material. Bacterial and fungal infections occur in equal numbers with Streptococcus pneumoniaeaccounting for the majority of bacterial ulcers and Fusariumspp responsible for most of the fungal infections. 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Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health &amp; Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Srinivasan, M</au><au>Gonzales, Christine A</au><au>George, Celine</au><au>Cevallos, Vicky</au><au>Mascarenhas, Jeena M</au><au>Asokan, B</au><au>Wilkins, John</au><au>Smolin, Gilbert</au><au>Whitcher, John P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India</atitle><jtitle>British journal of ophthalmology</jtitle><addtitle>Br J Ophthalmol</addtitle><date>1997-11-01</date><risdate>1997</risdate><volume>81</volume><issue>11</issue><spage>965</spage><epage>971</epage><pages>965-971</pages><issn>0007-1161</issn><eissn>1468-2079</eissn><coden>BJOPAL</coden><abstract>AIMS/BACKGROUND To determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in Madurai, south India, and to identify the specific pathogenic organisms responsible for infection. METHODS All patients with suspected infectious central corneal ulceration presenting to the ocular microbiology and cornea service at Aravind Eye Hospital, Madurai, from 1 January to 31 March 1994 were evaluated. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined, and corneal cultures and scrapings were performed. RESULTS In the 3 month period 434 patients with central corneal ulceration were evaluated. A history of previous corneal injury was present in 284 patients (65.4%). Cornea cultures were positive in 297 patients (68.4%). Of those individuals with positive cultures 140 (47.1%) had pure bacterial infections, 139 (46.8%) had pure fungal infections, 15 (5.1%) had mixed bacteria and fungi, and three (1.0%) grew pure cultures ofAcanthamoeba. The most common bacterial pathogen isolated was Streptococcus pneumoniae, representing 44.3% of all positive bacterial cultures, followed by Pseudomonas spp (14.4%). The most common fungal pathogen isolated was Fusariumspp, representing 47.1% of all positive fungal cultures, followed by Aspergillus spp (16.1%). CONCLUSIONS Central corneal ulceration is a common problem in south India and most often occurs after a superficial corneal injury with organic material. Bacterial and fungal infections occur in equal numbers with Streptococcus pneumoniaeaccounting for the majority of bacterial ulcers and Fusariumspp responsible for most of the fungal infections. These findings have important public health implications for the treatment and prevention of corneal ulceration in the developing world.</abstract><cop>BMA House, Tavistock Square, London, WC1H 9JR</cop><pub>BMJ Publishing Group Ltd</pub><pmid>9505820</pmid><doi>10.1136/bjo.81.11.965</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
Child
Child, Preschool
Corneal Ulcer - epidemiology
Corneal Ulcer - etiology
corneal ulceration
developing world
Diseases of cornea, anterior segment and sclera
epidemiology
Eye Infections, Bacterial - complications
Eye Infections, Bacterial - epidemiology
Eye Infections, Fungal - complications
Eye Infections, Fungal - epidemiology
Eye Injuries - complications
Female
Fusarium - isolation & purification
Humans
India - epidemiology
Infant
Infant, Newborn
Male
Medical sciences
microbial keratitis
Middle Aged
Ophthalmology
Original articles - Clinical science
Pseudomonas - isolation & purification
Pseudomonas Infections - complications
Risk Factors
Streptococcal Infections - complications
Streptococcus pneumoniae - isolation & purification
Tropical medicine
title Epidemiology and aetiological diagnosis of corneal ulceration in Madurai, south India
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