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Table 5 Comparison of microbiological and clinical data on fungal keratitis from studies from various parts of India

From: Diagnosis and treatment outcome of mycotic keratitis at a tertiary eye care center in eastern india

Parameters Bharathi et al (South)[2] Despande et al(West) [6] Saha et al
(North East)[7]
Chander & Sharma
(North)[4]
Present study
(East)
General
Type of study Retrospective Prospective Retrospective Prospective Retrospective
Period of study Sep1999-Aug2002 1988-1996 2008 Jan1987-Dec1992 July2006-Dec2009
Duration 3 years 9 years 1 year 6 years 3.5 years
No. of patients with microbial keratitis 3183 1010 289 730 997
Microbiology
Culture positive for fungus 1171(36.7%) 367(36.3%) 74(25.6%) 53(7.3%) 215(21.5%)
Nature of sample from which fungus isolated
Corneal scraping 1171/1171(100%) 367/367(100%) 41/74(55.4%) NM 172/215(80.0%)
Corneal tissue NM NM 16/74(21.6%) NM 7/215(3.2%)
Corneal scraping and tissue NM NM NM NM 36/215(16.7%)
Analysis of wet mount and different staining methods
KOH/CFW
positive
1181/1181
(100%)
367(36.3%) 110(38.06%) NM 238/251(94.8%)
Gram
positive
1039/1181
(87.9%)
347(34.4%) NM NM 199/252(78.9%)
Giemsa
Positive
NM NM NM NM 83/105(79.0%)
Smear positive
Culture negative
11/1181(0.9%) 0 36/289(12.4%) NM 49/257(19.0%)
Fungal culture
Positive
1095/1181(92.7)% 36.3% 74/110(67.2%) 7.3% 215/264(81.4%)
Most common
Fungal isolate
Fusarium spp. (43%) Aspergillus
spp. (67.8%)
Aspergillus
spp. (55%)
Aspergillus
spp. (40%)
Aspergillus
spp. (28%)
2nd common isolate Aspergillus
spp. (26%)
Candida spp. (9.8%) Candida spp. (19%) Fusarium spp. (16.4%) Fusarium spp. (23%)
Concomitant infection
Mixed with bacteria 76/1181(6.4%) 40/367(10.8%) NM NM 17%
Most common
Bacterial isolate
NM Pseudomonas aeruginosa (66%) NM NM Staphylococcus
spp. (31%)
Clinical aspect
Age Range 31-40(24%) 31-40 50-60 51-60 50-60 (63%)
Gender Male (65%) Male Male Male Male (70%)
Residence
Rural
80.3% NM NM NM 79.5%
Urban 20%     21%
Most common predisposing factor Trauma (92%) Trauma (55%) Trauma (48%) NM Trauma (40%)
Occupation Farmer (65%) NM NM NM Farmer (28%)
Clinical Diagnosis
Fungal keratitis 94.1% 100% NM NM 71%
Bacterial keratitis NM NM NM NM 9%
Viral keratitis NM NM NM NM 1.5%
Acanthoemba keratitis NM NM NM NM 0.4%
Treatment given
Topical natamycin or voriconazole NM NM 100% NM 94.3%
Systemic ketoconazole NM NM 100% NM 60%
Therapeutic PK NM NM 60% NM 21%
Evisceration NM NM NM NM 3.4%
Treatment outcome
Scar NM NM 40% NM 35%
Healing time
< 3 weeks
NM NM NM NM 32%
Duration of symptoms
Early onset
< 10 days
NM NM NM NM 92(34.8%)
Late onset
> 10 days
NM NM NM NM 172(65.2)