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Is inclusion of Sabouraud dextrose agar essential for the laboratory diagnosis of fungal keratitis?
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MedLine Citation:
PMID:  21586864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Authors:
Jayaraman Kaliamurthy; Philip A Thomas
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Publication Detail:
Type:  Comment; Letter    
Journal Detail:
Title:  Indian journal of ophthalmology     Volume:  59     ISSN:  1998-3689     ISO Abbreviation:  Indian J Ophthalmol     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-09-12     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0405376     Medline TA:  Indian J Ophthalmol     Country:  India    
Other Details:
Languages:  eng     Pagination:  263-4     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Agar / diagnostic use*
Clinical Laboratory Techniques*
Eye Infections, Fungal / diagnosis*
Humans
Keratitis / microbiology*
Chemical
Reg. No./Substance:
9002-18-0/Agar
Comments/Corrections
Comment On:
Indian J Ophthalmol. 2010 Jul-Aug;58(4):281-6   [PMID:  20534916 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Full Text
Journal Information
Journal ID (nlm-ta): Indian J Ophthalmol
Journal ID (publisher-id): IJO
ISSN: 0301-4738
ISSN: 1998-3689
Publisher: Medknow Publications, India
Article Information
Copyright: © Indian Journal of Ophthalmology
open-access:
Print publication date: Season: May-Jun Year: 2011
Volume: 59 Issue: 3
First Page: 263 Last Page: 264
ID: 3120262
Publisher Id: IJO-59-263
PubMed Id: 21586864
DOI: 10.4103/0301-4738.81037

Is inclusion of Sabouraud dextrose agar essential for the laboratory diagnosis of fungal keratitis?
Jayaraman Kaliamurthyaff1
Philip A Thomasaff1
Department of Ocular Microbiology, Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli – 620 001, Tamil Nadu, India
Correspondence: Correspondence to: Dr. Philip A Thomas, Department of Ocular Microbiology, Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli – 620 001, Tamil Nadu, India. E-mail: philipthomas@sify.com

Dear Editor,

We read with great interest the article by Das et al.[1] describing the status of inclusion of Sabouraud dextrose agar for laboratory diagnosis of fungal keratitis. The authors performed the study on 26 patients with culture-proven fungal keratitis. The authors have provided compelling evidence for the use of blood agar (BA) and chocolate agar (CA) for diagnosis of both bacterial and fungal keratitis in situations where resources are limited. We also agree with the points discussed by the authors. However, we have concerns regarding the statement related to estimated savings if only BA/CA are used, the saving being Rs. 600 per patient. The cost of 500 g of various types of dehydrated Sabouraud dextrose agar (SDA) ranges from Rs. 1406 to Rs. 1943 (Catalogue 2009–10, HiMedia, Mumbai, India). The quantity of the ready-made mixture used for the preparation of a 1000-ml medium is only 45–80 g (depends upon the type of SDA). We can prepare 40–50 plates (approximately 20 ml/plate) from the 1000-ml medium. The disposable petriplate costs around Rs. 12 per plate. We would very much like to know how the estimated saving for excluding SDA alone is Rs. 600. If so, the estimate for the whole process for the corneal scrapes per case sounds very high.

The authors have included potassium hydroxide with calcofluor white stains as part of the standard protocol. The safe-life of an ultraviolet (UV) lamp is only 200 h. The cost of one UV bulb will be Rs. 40,000. The working cost of this set-up may be higher than one SDA plate per case. Hence, one perfect Gram-stained smear reviewed by more than one person with adequate experience in ocular microbiology is perhaps sufficient to diagnose mycotic and bacterial keratitis. The authors did not mention about the exclusion of potassium hydroxide with calcofluor white stains to reduce the working cost.


References
1. Das S,Sharma S,Kar S,Sahu SK,Samal B,Mallick A. Is inclusion of Sabouraud dextrose agar essential for the laboratory diagnosis of fungal keratitis?Indian J OphthalmoloYear: 2010582815

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