Comparison of the clinico-microbiological features and outcomes in patients with bacterial keratitis caused by biofilm producing and non –biofilm producing bacteria

Bacterial keratitis is an infection of cornea causedby invasion and multiplication of bacteriaassociated with inflammation ofstroma .

Pain , redness, photophobia and blurred vision aretypical symptoms. Bacterial keratitis cancomplicate to corneal scarring andeven perforation, which can lead to total visual loss  .

Corneal opacity is the fifth leading cause ofblindness globally, affecting approx. 6 million ofworldpopulation. Inadditionit is responsible for 1.5-2.0 million new cases of monocular

blindness highlighting an ongoing uncurbed burden onhuman health.

Contact lens wear is the most common risk factor forbacterial keratitis in urbanized world,while in developing country like India,trauma with contaminated water, soil and vegetative

matter which deliver heavy microbial loads, foreignbodies and diverse microbiota to ocular surface  .The most common causative organism forbacterial keratitis is Staphylococcusspp.,

Streptococcus spp. and gram negative bacilli such asPseudomonas spp., and many of themare associated with biofilm production  .

Biofilm is a slimy layer of a extra cellular matrixmade of polymeric substances, formed by sessile cells and can grow onto bothbiotic and abiotic surfaces.Biofilms form an architectural colony providingresistance not only against antibiotics but also against human

immune system. Biofilm provides protection tobacteria from altered pH, osmolarity, nutrient scarcity , mechanical forces andconfers antibiotic resistance through numerous mechanisms, thus making thesebacteria very dangerous and difficult to treat.