title: Epidemiology of Aspergillus keratitis at a tertiary care eye hospital in South India and antifungal susceptibilities of the causative agents.
abstract: In recent years, Aspergillus species are reported frequently as aetiological agents of fungal keratitis in tropical countries such as India. Our aim was to evaluate the epidemiological features of Aspergillus keratitis cases over a 3-year period in a tertiary eye care hospital and to determine the antifungal susceptibilities of the causative agents. This study included culture proven Aspergillus keratitis cases diagnosed between September 2005 and August 2008. Data including prevalence, predisposing factors and demography were recorded, the isolates were identified by morphological and molecular methods and the minimum inhibitory concentration values of antifungal agents towards the isolates were determined by the microdilution method. Two hundred Aspergillus isolates were identified among 1737 culture proven cases. Most of the aspergilli (75%) proved to be A. flavus, followed by A. fumigatus (11.5%). Sixteen (8%) isolates belonged to species that are recently identified causative agents of mycotic keratitis. Most of the infected patients (88%) were adults ranging from 21 to 70 years of age. Co-existing ocular disease was confirmed in 16.5% of the patients. Econazole, clotrimazole and ketoconazole were notably active against A. flavus. Aspergillus keratitis is a significant problem in patients with ocular lesions in South-Indian States, warranting early diagnosis and initiation of specific antifungal therapy to improve outcome.
authors.affiliation: Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamilnadu, India.
authors.forename: Palanisamy
authors.initials: P
authors.lastname: Manikandan
authors.forename: János
authors.initials: J
authors.lastname: Varga
authors.forename: Sándor
authors.initials: S
authors.lastname: Kocsubé
authors.forename: Raghavan
authors.initials: R
authors.lastname: Anita
authors.forename: Rajaraman
authors.initials: R
authors.lastname: Revathi
authors.forename: Tibor Mihály
authors.initials: TM
authors.lastname: Németh
authors.forename: Venkatapathy
authors.initials: V
authors.lastname: Narendran
authors.forename: Csaba
authors.initials: C
authors.lastname: Vágvölgyi
authors.forename: Kanesan
authors.initials: K
authors.lastname: Panneer Selvam
authors.forename: Coimbatore Subramanian
authors.initials: CS
authors.lastname: Shobana
authors.forename: Yendremban Randhir
authors.initials: YR
authors.lastname: Babu Singh
authors.forename: László
authors.initials: L
authors.lastname: Kredics
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D001228:Aspergillosis / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015821:Eye Infections, Fungal / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007634:Keratitis / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents