Bacterial etiology of Keratitis and their antimicrobial susceptibility pattern at a tertiary care hospital.

  • Fahd Kamal Akhtar AMC/PGMI/LGH
  • Zubair Saleem AMC/PGMI/LGH
  • Muna Malik AMC/PGMI/LGH
  • Adeel Chaudhry
  • Ayesha Sajjad
  • Abdul Mudabbir Rehan
Keywords: Bacterial keratitis, antimicrobial susceptibility.


The aim of this study was to find out Bacterial etiology and antimicrobial susceptibility pattern of bacteria causing infective keratitis at a tertiary care hospital of Lahore
Study Design:Descriptive cross sectional study
Study Place and Study Period: PGMI/AMC/LGH, Lahore, in 2015 - 2018.
Sample Collection: Non-probability convenience sampling
Material and Methods:
The corneal scrapings taken by the ophthalmologist was immediately inoculated on Chocolate agar, Blood agar and MacConkay agar culture plates with the help of sterilized wire loop in the operation theater.These plates were taken to laboratory for incubation and further microbiological processing.
After inoculating on the culture agar plates, the scrapings from cornea were smeared on glass slides with the help of sterilized wire loop. The smears were air-dried stained with Gram’s stain, Kinyoun stain and Giemsa stain. The culture and staining were further processed for microbiological analysis of bacterial etiology and antimicrobial susceptibility.
Results:7 of each cases of Staphylococcus aureus and Streptococcus pneumoniae were isolated accounting 28% of total bacteria. Gram negative bacteria are relatively sensitive to all groups of antibiotics as compared to Gram positive bacteria who were resistant of major groups of antibiotic like Fluoroquinolones and aminoglycosides.
We concluded that a cumulative antimicrobial data should be published from laboratory on antimicrobial susceptibiblity pattern of bacterial keratitis for its empirical treatment.

Author Biographies

Fahd Kamal Akhtar, AMC/PGMI/LGH

MS Ophthalmology, MCPS, DOMS
Senior registrar

Ophthalmology dept, LGH

Zubair Saleem, AMC/PGMI/LGH

FCPS ophthalmology
Associate professor of ophthalmology

Ophthalmology dept,

Muna Malik, AMC/PGMI/LGH

M.Phill Microbiology
Assistant professor of Pathology

Department of Pathology AMC/PGMI/LGH

Adeel Chaudhry

Senior registrar

Ophthalmology dept, LGH

Ayesha Sajjad

M.Phill Microbiology
Assistant professor of Pathology

Department of Pathology, 
Amna Inayat medical college

Abdul Mudabbir Rehan

M.Phill Pharmacology,
Assistant Professor, Pharmacology

Department of Pharmacology,
DG Khan Medical College, DG Khan


1. Musa F, Tailor R, Gao A, Hutley E, Rauz S, Scott RA. Contact lens-related microbial keratitis in deployed British military personnel. British Journal of Ophthalmology. 2010 Aug 1;94(8):988-93.
2. Hsiao CH, Sun CC, Yeh LK, Ma DH, Chen PY, Lin HC, Tan HY, Chen HC, Chen SY, Huang YC. Shifting trends in bacterial keratitis in Taiwan: a 10-year review in a tertiary-care hospital. Cornea. 2016 Mar 1;35(3):313-7.
3. Shah A, Sachdev A, Coggon D, Hossain P. Geographic variations in microbial keratitis: an analysis of the peer-reviewed literature. British Journal of Ophthalmology. 2011 Jun 1;95(6):762-7.
4. Gokhale NS. Medical management approach to infectious keratitis. Indian journal of ophthalmology. 2008 May;56(3):215.
5. Wong RL, Gangwani RA, Yu LW, Lai JS. New treatments for bacterial keratitis. Journal of ophthalmology. 2012 Sep 6;2012.
6. Bhadange Y, Das S, Kasav MK, Sahu SK, Sharma S. Comparison of culture-negative and culture-positive microbial keratitis: cause of culture negativity, clinical features and final outcome. British Journal of Ophthalmology. 2015 Nov 1;99(11):1498-502.
7. Marasini S, Swift S, Dean SJ, Ormonde SE, Craig JP. Spectrum and sensitivity of bacterial keratitis isolates in Auckland. Journal of ophthalmology. 2016;2016.
8. Shanthi J, Vanajapriya R, Balagurunathan R. Laboratory diagnosis and prevalence study of corneal infections from a tertiary eye care hospital. Adv. Appl. Science Res. 2012;3(3):1598-602.
9. Mohammadinia M, Rahmani S, Eslami G, Ghassemi-Broumand M, Amiri MA, Aghaie G, Tabatabaee SM, Taheri S, Behgozin A. Contact lens disinfecting solutions antibacterial efficacy: comparison between clinical isolates and the standard ISO ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus. Eye. 2012 Feb;26(2):327.
10. Lakhundi S, Siddiqui R, Khan NA. Pathogenesis of microbial keratitis. Microbial pathogenesis. 2017 Mar 1;104:97-109.
11. Tang A, Marquart ME, Fratkin JD, McCormick CC, Caballero AR, Gatlin HP, O'Callaghan RJ. Properties of PASP: a Pseudomonas protease capable of mediating corneal erosions. Investigative ophthalmology & visual science. 2009 Aug 1;50(8):3794-801.
12. Taube MA, del Mar Cendra M, Elsahn A, Christodoulides M, Hossain P. Pattern recognition receptors in microbial keratitis. Eye. 2015 Nov;29(11):1399.
13. Kanski JJ, Bowling B. Clinical ophthalmology: a systematic approach. Elsevier Health Sciences; 2011 Apr 28.
14. Procop GW, Church DL, Hall GS, Janda WM. Koneman's Color Atlas and Textbook of Diagnostic. Philadelphia: Wolters Kluwer; 2017.
15. Cheesbrough M. District laboratory practice in tropical countries. Cambridge university press; 2006 Mar 2.
16. Peng MY, Cevallos V, McLeod SD, Lietman TM, Rose-Nussbaumer J. Bacterial Keratitis: Isolated Organisms and Antibiotic Resistance Patterns in San Francisco. Cornea. 2018 Jan;37(1):84-7.
17. Deorukhkarl S, Katiyarl R, Sainil S. Epidemiological features and laboratory results of bacterial and fungal keratitis: five-year study at tertiary-care hospital in western Maharashtra, India. Singapore Med J. 2012;53(4):264.
18. Ray KJ, Prajna L, Srinivasan M, Geetha M, Karpagam R, Glidden D, Oldenburg CE, Sun CQ, McLeod SD, Acharya NR, Lietman TM. Fluoroquinolone treatment and susceptibility of isolates from bacterial keratitis. JAMA ophthalmology. 2013 Mar 1;131(3):310-3.
19. Hsiao CH, Sun CC, Yeh LK, Ma DH, Chen PY, Lin HC, Tan HY, Chen HC, Chen SY, Huang YC. Shifting trends in bacterial keratitis in Taiwan: a 10-year review in a tertiary-care hospital. Cornea. 2016 Mar 1;35(3):313-7.
20. Nahar K, Islam MS. Antibiotic susceptibility pattern of bacteria isolated from corneal ulcer in a tertiary level eye hospital. Bangladesh Medical Research Council Bulletin. 2014;40(3):122-3.
21. Watson S, Cabrera‐Aguas M, Khoo P, Pratama R, Gatus BJ, Gulholm T, El‐Nasser J, Lahra MM. Keratitis antimicrobial resistance surveillance program, Sydney, Australia: 2016 Annual Report. Clinical & experimental ophthalmology. 2019 Jan;47(1):20-5.
How to Cite
Akhtar F, Saleem Z, Malik M, Chaudhry A, Sajjad A, Rehan A. Bacterial etiology of Keratitis and their antimicrobial susceptibility pattern at a tertiary care hospital. pjo [Internet]. 23Jan.2020 [cited 26Sep.2020];35(4):271-5. Available from:
Original Article