Analysis of antimicrobial susceptibility pattern of ocular infections at Regional Ophthalmic Institute in India

Qudsia Nuzhat, Arkapal Bandyopadhyay, Rakesh Chandra Chaurasia, Satya P. Singh, Monica Singh


Background: Ocular infections are a result of alteration in the normal microbial flora of eye. They are not only responsible for increase in morbidity varying from self-limiting trivial infection to sight threatening infection but also blindness.

Methods: Patients with ocular infections were recruited at Regional Institute of Ophthalmology, Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh. Bacterial profile in ocular infections and susceptibility pattern to commonly used antibiotics were analyzed amongst these patients. The isolated organism was then identified by colony morphology, gram stain and biochemical test following which in vitro susceptibility test was performed by Kirby-Bauer disc diffusion method and interpreted clinically.

Results: Staphylococcus aureus and coagulase negative Streptococcus were most common etiological agents of ocular infections in the present study.  It was observed that bacterial isolates were highly (in 100% of cases) susceptible to vancomycin and chloramphenicol among gram positive organisms. Gram negative organisms showed higher susceptibility to moxifloxacin, tobramycin and gentamycin. Pseudomonas was seen to have sensitivity towards ceftazidime and cefazolin.

Conclusions: The present study gives an insight into use of ocular antimicrobials in northern India. These findings illustrate the need for constant bacterial surveillance before starting empirical treatment.


Antibiotics, Bacteria, Infections, Ocular, Resistance

Full Text:



Ramesh S, Ramakrishnan R, Bharathi M, Amuthan M, Viswanathan S. Prevalence of bacterial pathogens causing ocular infections in South India. Indian Pathol Microbiol. 2010;53:281-6.

Kunimoto DY, Das T, Sharma S. Microbiologic spectrum and susceptibility of isolates: part 1. Postoperative endophthalmitis. Endophthalmitis Research Group. Am J Ophthalmol. 1999;128:240-2.

Behlau I, Gilmore MS. Microbial Biofilms in Ophthalmology and Infectious Disease. Arch Ophthalmol. 2008;126:1572-81.

Chung JL, Seo KY, Yong DE, Mah FS, Kim T, Kim EK. Antibiotic susceptibility of conjunctival bacterial isolates from refractive surgery patients. Ophthalmology. 2009;116(6):1067-74.

Sharma S. Antibiotic resistance in ocular bacterial pathogens. Indian J Med Microbiol. 2011;29:218-22.

Brown L. Resistance to ocular antibiotics: an overview. Clin.Exp Optom. 2007;90(4).258-62.

Lee K, Lee H, Kim M. Two cases of corneal ulcer due to methicillin-resistant Staphylococcus aureus in high risk groups. Korean J Ophthalmol. 2010;24(4):240-4.

Joseph S, Bertino JR. Impact of antibiotic resistance in the management of ocular infections: the role of current and references 61 future antibiotics. Clin Ophthalmol. 2009;3:507-21.

Cheesbrough M. Medical laboratory manual for tropical countries: microbiology. Vol. 2. Butterworth and Co Ltd, Combridgeshire, England; 1984:479-490.

Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Medical Statistics. Arch Orofac Sci. 2006;1:9-14.

Wayne PA. Clinical and laboratory standards institute, performance standards for antimicrobial susceptibility testing. Inform Suppl. 2007;27(1):23-138.

Shiferaw B, Gelaw B, Assefa A, Assefa Y, Addis Z. Bacterial isolates and their antimicrobial susceptibility pattern among patients with external ocular infections at Borumeda hospital, Northeast Ethiopia. BMC Ophthalmol. 2015;15(1):103.

Bharathi MJ, Ramakrishnan R, Shivakumar C, Meenakshi R, Lionalraj D. Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India. Indian J Ophthalmol. 2010;58:497-507.

Khaja M, Nazeer HA, Anandi S, Prakash B, Murlidhar A. Bacteriology and antimicrobial susceptibility pattern of external ocular infections in rural tertiary care teaching hospital. Indian J Microbiol Res. 2016;3(2):203-8.

Srinivasan M, Gonzales CA, George C, Cevallos V, Mascarenhas JM. Epidemiology and aetiological diagnosis of corneal ulceration in Madurai. South India. Br J Ophthalmol. 1997;8:965-71.

Sharma S, Kunimoto DY, Garg P. Trends in antibiotic resistance of corneal pathogens: Part I. An analysis of commonly used ocular antibiotics. Indian J Ophthalmol. 1999;47:95-100.

Mohammad A. Etiology and antibacterial susceptibility pattern of bacterial ocular infections in a children hospital in North Jordan (2005-2009). Biomed Pharmacol J. 2012;5(1).

Maurer PP, Zbinden R, Kaufmann C, Thiel M. Antibiotic susceptibilities of bacteria isolated from ophthalmic specimens between 1984 and 2005 in Zurich, Switzerland. Klin Monatsbl Augenheilkd. 2007;224:240-3.

Nithya V, Rathinam S, Siva Ganesa Karthikeyan R, Lalitha P. A ten year study of prevalence, antimicrobial susceptibility pattern, and genotypic characterization of Methicillin resistant Staphylococcus aureus causing ocular infections in a tertiary eye care hospital in South India. Infect Genet Evol. 2019;69:203-10.