title: Trends in bacterial and fungal keratitis in South India, 2002-2012.
abstract: OBJECTIVE
  To assess the trends in microbiological organisms identified from corneal scrapings from patients with infectious keratitis at a tertiary care medical centre in South India.
  
  
  METHODS
  We reviewed the records of the microbiology laboratory at Aravind Eye Hospital in Madurai, India, from 2002 until 2012. We identified the microbiological causes of all corneal ulcers from the culture and smear results, and assessed for trends in bacterial and fungal keratitis over time.
  
  
  RESULTS
  Of 23 897 corneal patients with ulcer with a corneal smear from 2002 to 2012 a fungal organism was identified in 34.3%, a bacterial organism in 24.7% and no organism in 38.3%. During this period, the annual number of keratitis cases due to bacteria decreased from 677 to 412, and the annual number due to fungus increased from 609 to 863. In analyses accounting for the total number of outpatients seen each year, the decline in number of smears positive for bacteria was statistically significant (p<0.001) but the increase in the number positive for fungus was not (p=0.73). The relative frequency of individual bacterial or fungal organisms remained relatively stable over this time.
  
  
  CONCLUSIONS
  At a tertiary eye care centre in South India, there has been a reduction in the numbers of smear-positive bacterial keratitis over the past 11 years. This decline likely reflects economic development in India and increased access to antibiotics.
authors.affiliation: Department of Ocular Microbiology, Aravind Eye Care System, Madurai, India.
authors.forename: Prajna
authors.initials: P
authors.lastname: Lalitha
authors.affiliation: Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
authors.forename: Namperumalsamy V
authors.initials: NV
authors.lastname: Prajna
authors.affiliation: Department of Ocular Microbiology, Aravind Eye Care System, Madurai, India.
authors.forename: Geetha
authors.initials: G
authors.lastname: Manoharan
authors.affiliation: Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
authors.forename: Muthiah
authors.initials: M
authors.lastname: Srinivasan
authors.affiliation: Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
authors.forename: Jeena
authors.initials: J
authors.lastname: Mascarenhas
authors.affiliation: Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
authors.forename: Manoranjan
authors.initials: M
authors.lastname: Das
authors.affiliation: Department of Cornea and External Diseases, Aravind Eye Care System, Madurai, India.
authors.forename: Sean S
authors.initials: SS
authors.lastname: D'Silva
authors.affiliation: Francis I. Proctor Foundation, University of California, San Francisco, USA Department of Ophthalmology, University of California, San Francisco, USA Department of Epidemiology & Biostatistics, University of California, San Francisco, USA.
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
authors.affiliation: Francis I. Proctor Foundation, University of California, San Francisco, USA Department of Ophthalmology, University of California, San Francisco, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Keenan
mesh_terms: D001419:Bacteria / Q000302:isolation & purification; D003320:Corneal Ulcer / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000453:epidemiology* / Q000382:microbiology; D005658:Fungi / Q000302:isolation & purification; D006782:Hospitals, Special / Q000639:trends; D006801:Humans; D007194:India / Q000453:epidemiology; D009885:Ophthalmology / Q000639:trends*; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000639:trends*
keywords: Cornea; Microbiology