Original Article Indian Journal of Clinical and Experimental Ophthalmology, October – December 2015;1(4):264-272 264 Microbiological regional profile of infective keratitis Reena Gupta 1,* , Chekitaan Singh 2 , Bella Mahajan 3 , AK Khurana 4 1 Assistant Professor, 4 Senior Professor & HOD, PGIMS, Rohtak, 2 Senior Consultant, Ishwar Eye Centre, Rohtak, 3 Senior Professor & HOD, GMC, Jammu *Corresponding Author: Email: reenaguptasingh@rediffmail.com ABSTRACT Purpose: To determine epidemiological characteristics, specific pathogenic organisms, risk factors for infective keratitis. Methods: Patients with signs and symptoms of infective keratitis were included. History, examination including visual acuity, slit-lamp bio-microscopy, microbiological examination including Gram staining, KOH mount, culture, sensitivity of corneal scrapings were done. Results: Forty cases were evaluated, thirty (75%) were males, ten (25%) were females. Age ranged from 5 - 70 years, 35% in age group up to 30 years, 50% between 31-60 years, 15% were > 60 years of age. Right eye was involved in 55%, left in 45%. Highest incidence of ulcers occurred in farmers and labourers (65%). History of trauma was present in 80% patients, ocular surface disease in 7.5%. Diabetes was present in 12.5%. 57.5% patients had hypopyon on presentation. Based on culture reports 62.5% had bacterial keratitis, 25% fungal keratitis and 12.5% sterile. 80% bacterial isolates were gram positive and 20% gram negative. Staphylococcus aureus(40%) was the commonest organism cultured followed by Staphylococcus epidermidis(32%), Pseudomonas(12%), Pneumococcus(8%) and Acinetobacter(8%). Aspergillus was isolated in 60% of cases and Fusarium in 40%. Gram positive isolates were maximally sensitive to Cefazoline, gram negative isolates to Gentamicin. Conclusion: Males in rural agricultural population in economically productive age group are most vulnerable to infective keratitis. Culture on blood and chocolate agar detects more number of organisms compared to Gram stain alone. Staphylococcus aureus was the most common bacterium and Aspergillus most common fungus isolated. Cefazoline and Gentamicin combined cover most bacterial isolates. Key Words: Infective Keratitis 2 , epidemiological profile 1 , risk factors 3 Access this article online Quick Response Code: Website: www.innovativepublication.com DOI: 10.5958/2395-1451.2015.00026.8 INTRODUCTION Globally it is estimated that infective keratitis and ocular trauma result in 1.5 to 2 million new cases of corneal blindness annually. Ninety percent of them occur in developing countries, and it has now been recognized as a silent epidemic [1] . Corneal blindness is a major health problem in India and infections constitute the most predominant cause. A review of the data on indications for corneal transplantation in the developing world revealed that corneal scar was the most common indication (28.1%), of which keratitis accounted for 50.5%. 2 Successful therapy of a corneal ulcer requires accurate identification of the causative organism and initiation of appropriate anti-microbial therapy. Laboratory investigation is an essential part of the evaluation of any patient with suspected microbial keratitis. To maximize the comfort of the patient and to prevent loss of vision, and in most cases to increase the cost effectiveness of treatment, direct examinations, culture and antibiotic sensitivity is indicated in patients with microbial keratitis. We decided to conduct a study in order to evaluate the clinical profile of infective keratitis, role of various microbiological investigations in the diagnosis and management of infective keratitis. We determined the factors predisposing to infective keratitis, identified the causative agents prevalent and also analysed the sensitivity of antimicrobial agents commonly being used in developing countries like ours. MATERIALS AND METHODS All patients with symptoms and signs suggestive of infective keratitis presenting to the Upgraded Department of Ophthalmology, Government Medical College, Jammu in a period of one year were included in this study and prospectively analysed. All these cases were defined clinically as “corneal ulcers” following observation of loss of corneal epithelium with underlying stromal infiltration and suppuration associated with signs of inflammation, with or without hypopyon as seen on slit lamp bio- microscopic examination. Patients with typical viral ulcers, Mooren’s ulcers, marginal ulcers, interstitial keratitis, sterile neurotropic ulcers and perforated corneal ulcers were excluded from the study. At presentation to the outpatient department, information pertaining to the demographic features, duration of symptoms, risk factors, occupational status and details of previous treatment received was documented for every suspected case of infective keratitis according to a detailed