Purpose: To review the incidence, microbiological profile, antibiogram, clinical course, treatment, and outcome in patients with microbial keratitis due to Aeromonas species at a tertiary eye care center in Southern India.
Design: A retrospective, noncomparative study.
Methods: This study included all patients of corneal ulcer with a significant growth of Aeromonas species on culture of corneal scrapings managed at an eye institute in India between January 2005 and October 2011. The patients underwent standard diagnostic microbiological evaluation, and their treatment was guided by microbiology results and clinical response to therapy. Data were analyzed for the incidence, predisposing factors, clinical picture, microbiology, and the treatment outcome.
Results: Fifteen patients of microbial keratitis showed Aeromonas species to be the causative agent, constituting 0.5% of bacterial keratitis diagnosed during this period. Laboratory results showed that Aeromonas hydrophila was the predominant species isolated. Most of the isolates were susceptible to commonly used ocular antibiotics. Medical therapy resulted in resolution of infection in 9 (60%) of 15 cases. Five patients required application of cyanoacrylate tissue adhesive with bandage contact lens for corneal perforation. Two of the 5 patients needed penetrating keratoplasty for uncontrolled infection. Twelve of 15 patients had some local predisposing host factors for the infection.
Conclusions: Aeromonas species are uncommon but important causal agents of microbial keratitis. The organisms most often cause infection in individuals with local predisposing factors. Aeromonas hydrophila is the predominant species associated with keratitis. Although the organisms are susceptible to most antibiotics, a third of the patients required additional surgical intervention.