This is a retrospective review of microbiological records of 22 patients, who had presented at the LV Prasad Eye Institute, India, between June 2009 and December 2012. The corneal scrapings were performed in all patients and had yielded significant growth of Corynebacterium spp. Data was collected from each record including age, gender, predisposing factors (ocular and systemic), clinical presentation, management and outcome of treatment. The mean age of the patient was 43.8±24.4 years. Ocular predisposing factors were found in 14 (63.6%) of eyes. Surgical intervention was required in 12 (54.5%) patients. The predisposing ocular risk factors included: lagophthalmos, Mooren’s ulcer, failed graft, nasolacrimal duct obstruction, penetrating keratoplasty, Stevens Johnson Syndrome and entropion. In vitreo susceptibility results (Kirby-Bauer disc diffusion method) results of Corynebacterium spp to vancomycin (17/19, 89.5%), cefazolin (16/20, 80%), chloramphenicol (11/20, 55%), ofloxacin (13/19, 68.4%), ciprofloxacin (10/20, 50%) and gantifloxacin (10/19, 52.6%) were variable. Drug resistance (more than one drug) was seen in nine (40.9%) Corynebacterium isolates for two (22.2%) showed multidrug resistance to three or more classes of antibiotics. There were two patients who had diabetes mellitus. One patient had resistance to chloramphenicol, cefazolin and fluoroquinolones (ciprofloxacin and gatifloxacin), the other patient had resistance to chloramphenicol, cefazolin and vancomycin. The authors concluded that the ocular predisposing factors play an important role in the causation of keratitis due to Corynebacterium spp, which can lead to serious corneal infection and may need surgical intervention.

Corynebacterium spp as causative agents of microbial keratitis.
Da S, Rao AS, Sahu SK, Sharma S.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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