Role of Chlamydia trachomatis in the Aetiological Profile of Chronic Conjunctivitis in a Tertiary Care Hospital
Dr Gita Satpathy, MD, Professor. Department of Ocular Microbiology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.E-mail: firstname.lastname@example.org
Background: The aetiological profile of chronic conjunctivitis in North-Indian patients is poorly understood; and clinical assessment remains the diagnostic criteria without supportive laboratory investigations. This study was conducted to find out the presence of Chlamydia trachomatis and other bacteria in the conjunctiva of patients with clinically diagnosed chronic conjunctivitis, attending the out-patient department of a tertiary eye-care hospital in Delhi.
Methods: One hundred eyes from 50 patients of chronic conjunctivitis and an equal number of apparently healthy controls were included in the study. Conjunctival swabs were collected from the superior/inferior palpebral conjunctiva and eye-lid margins with a sterile wet cotton swab for chlamydial antigen detection by direct immunofluorescence (DFA), bacterial culture, and cytology.
Results: Patients with chronic conjunctivitis revealed 38% positivity for C.trachomatis antigen alone, and 15% for mixed bacterial and chlamydial infections, while in the control group, only 2 eyes were positive for chlamydial antigen, and 19 for other bacterial flora. Among bacterial isolates (28), coagulase â€“ve staphylococci (21) predominated, followed by coagulase +ve staphylococcus (4), dipheroids (2), and aerobic spore-bearing bacilli (1). In cytology (with geimsa stain), inflammatory response was observed; the combination of polymorphs with lymphocyts (62) outnumbered the combination of polymorphs with eosinophils (37) in the case of chronic conjunctivitis.
Conclusions: Findings of the present study suggest that C.trachomatis continues to be the leading cause of chronic conjunctivitis in North India. However, surveillance involving larger groups of patients is warranted to further augment our observation.