{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:25:27Z","timestamp":1787840727575,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To identify the predisposing factors, clinico-microbiological profiles, and treatment responses in patients with atypical mycobacterial keratitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study retrospectively analyzed patients who presented at a tertiary eyecare center in eastern India with atypical mycobacterial keratitis between 2008 and 2021. The diagnostic criteria included cases positive for acid-fast bacilli on Ziehl\u2013Nielsen stain or culture. The antibiotic susceptibility pattern was observed, and treatment was initiated accordingly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of the 29 cases, ocular predisposing factors were present in 62.1% with an antecedent history of trauma, and vegetative matter was the most common risk factor. There was no predisposing association with systemic conditions in any case. A long lag time was observed between the onset of corneal infection and presentation in 79.3% of cases, with the average time being 43.7 days. Clinical signs mimicked fungal keratitis in most cases. Typical cracked windshield appearance was only observed in two cases. Two patients presented with clinical pictures like peripheral ulcerative keratitis. Topical amikacin was used as treatment in 28 cases. Based on disk diffusion assay, 28 (96.5%) isolates were sensitive to amikacin. Twelve (41.3%) were sensitive to vancomycin, six (20.6%) to gatifloxacin, six (20.6%) to ciprofloxacin, and four (13.7%) to moxifloxacin. Twelve participants showed good final visual acuity posttreatment, which improved to over two lines of Snellen\u2019s visual acuity chart (44.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Atypical mycobacteria keratitis may not present with classically described clinical features. The duration of presentation, clinical presentation, special microbiological stains, targeted therapy, and antibiotic susceptibility patterns are the key to successfully managing these intractable infections and obtaining favorable outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_3338_23","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:00:14Z","timestamp":1723640414000},"page":"404-407","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Atypical mycobacterial keratitis: Clinical outcome in nonrefractive surgery cases"],"prefix":"10.4103","volume":"73","author":[{"given":"Kshyanaprava","family":"Priyadarshini","sequence":"first","affiliation":[{"name":"Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smruti Rekha","family":"Priyadarshini","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikant Kumar","family":"Sahu","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himansu Sekhar","family":"Behera","sequence":"additional","affiliation":[{"name":"Ocular Microbiology Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujata","family":"Das","sequence":"additional","affiliation":[{"name":"Cornea and Anterior Segment Service, L V Prasad Eye Institute, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1016\/S0161-6420(95)30771-3","article-title":"The importance of initial management in the treatment of severe infectious corneal ulcers","volume":"102","author":"McLeod","year":"1995","journal-title":"Ophthalmology"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1136\/bjo.72.12.926","article-title":"Predisposing factors in microbial keratitis: The significance of contact lens wear","volume":"72","author":"Dart","year":"1988","journal-title":"Br J Ophthalmol"},{"key":"R3-20260422","first-page":"125","article-title":"Contact lens-related microbial keratitis: Part I: Epidemiology","volume":"16","author":"Liesegang","year":"1997","journal-title":"Cornea"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1136\/bjo.85.7.842","article-title":"Bacterial keratitis: A prospective clinical and microbiological study","volume":"85","author":"Schaefer","year":"2001","journal-title":"Br J Ophthalmol"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1001\/archopht.122.8.1166","article-title":"Comparative efficacy of topical gatifloxacin with ciprofloxacin, amikacin, and clarithromycin in the treatment of experimental Mycobacterium chelonae keratitis","volume":"122","author":"Hyon","year":"2004","journal-title":"Arch Ophthalmol"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S0255-0857(21)02768-7","article-title":"Ocular infections due to non-tuberculous mycobacteria","volume":"22","author":"Lalitha","year":"2004","journal-title":"Indian J Med Microbiol"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1136\/bjo.80.11.962","article-title":"Non-tuberculous mycobacterial keratitis: A study of 22 cases","volume":"80","author":"Huang","year":"1996","journal-title":"Br J Ophthalmol"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1016\/j.ajo.2007.11.024","article-title":"Infectious scleritis after retinal surgery","volume":"145","author":"Rich","year":"2008","journal-title":"Am J Ophthalmol"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1097\/01.iae.0000244276.80716.96","article-title":"Mycobacterium abscessus endophthalmitis: Treatment dilemma and review of the literature","volume":"26","author":"Matieli","year":"2006","journal-title":"Retina"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1111\/j.1442-9071.2011.02679.x","article-title":"Ocular infections caused by non-tuberculous mycobacteria: Update on epidemiology and management","volume":"40","author":"Girgis","year":"2012","journal-title":"Clin Exp Ophthalmol"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1016\/S0161-6420(98)99034-0","article-title":"Nontuberculous mycobacterial keratitis in south Florida","volume":"105","author":"Ford","year":"1998","journal-title":"Ophthalmology"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/S0008-4182(05)80094-8","article-title":"Fourth-generation fluoroquinolones in the treatment of mycobacterial infectious keratitis after laser-assisted in situ keratomileusis surgery","volume":"40","author":"Lee","year":"2005","journal-title":"Can J Ophthalmol"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0161-6420(98)80018-3","article-title":"Topical ciprofloxacin for treating nontuberculous mycobacterial keratitis","volume":"105","author":"Hu","year":"1998","journal-title":"Ophthalmology"},{"key":"R14-20260422","first-page":"667","article-title":"Atypical mycobacterial infections in ophthalmology","volume":"68","author":"Turner","year":"1970","journal-title":"Trans Am Ophthalmol Soc"},{"key":"R15-20260422","first-page":"3","article-title":"Anonymous mycobacteria in human disease","author":"Runyon","year":"1960","journal-title":"The anonymous mycobacteria in human disease"},{"key":"R16-20260422","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1128\/CMR.15.4.716-746.2002","article-title":"Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria","volume":"15","author":"Brown-Elliott","year":"2002","journal-title":"Clin Microbiol Rev"},{"key":"R17-20260422","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/00003226-199503000-00009","article-title":"Therapeutic lamellar keratectomy in the management of nontuberculous Mycobacterium keratitis refractory to medical treatments","volume":"14","author":"Tseng","year":"1995","journal-title":"Cornea"},{"key":"R18-20260422","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3928\/1081-597X-19980501-21","article-title":"Mycobacterium chelonae keratitis following laser in situ keratomileusis","volume":"14","author":"Reviglio","year":"1998","journal-title":"J Refract Surg"},{"key":"R19-20260422","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/clinids\/5.4.657","article-title":"Spectrum of disease due to rapidly growing mycobacteria","volume":"5","author":"Wallace","year":"1983","journal-title":"Rev Infect Dis"},{"key":"R20-20260422","doi-asserted-by":"crossref","first-page":"3283","DOI":"10.1128\/AAC.46.10.3283-3285.2002","article-title":"Comparison of in vitro activities of gatifloxacin and ciprofloxacin against four taxa of rapidly growing mycobacteria","volume":"46","author":"Brown-Elliott","year":"2002","journal-title":"Antimicrob Agents Chemother"},{"key":"R21-20260422","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1128\/AAC.47.6.1958-1962.2003","article-title":"High prevalence of antimicrobial resistance in rapidly growing mycobacteria in Taiwan","volume":"47","author":"Yang","year":"2003","journal-title":"Antimicrob Agents Chemother"},{"key":"R22-20260422","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1167\/iovs.10-5593","article-title":"Effects of photodynamic therapy on rapidly growing nontuberculous mycobacteria keratitis","volume":"52","author":"Shih","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R23-20260422","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3109\/02713680903502258","article-title":"In vitro antibiotic susceptibility of rapidly growing nontuberculous mycobacteria isolated from patients with microbial keratitis","volume":"35","author":"Reddy","year":"2010","journal-title":"Curr Eye Res"},{"key":"R24-20260422","doi-asserted-by":"crossref","first-page":"160","DOI":"10.18502\/jovr.v17i2.10786","article-title":"Clinico-microbiological Profile of Nontuberculous Mycobacterial Keratitis","volume":"17","author":"Dhiman","year":"2022","journal-title":"J Ophthalmic Vis Res"},{"key":"R25-20260422","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.survophthal.2004.02.007","article-title":"Infections following laser in situ keratomileusis: An integration of the published literature","volume":"49","author":"Chang","year":"2004","journal-title":"Surv Ophthalmol"},{"key":"R26-20260422","doi-asserted-by":"crossref","first-page":"232-8.e1","DOI":"10.1016\/j.ophtha.2009.07.011","article-title":"Infectious keratitis in 204 586 LASIK procedures","volume":"117","author":"Llovet","year":"2010","journal-title":"Ophthalmology"},{"key":"R27-20260422","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/archopht.1983.01040020751018","article-title":"Intrastromal noninflammatory bacteria colonization of a corneal graft","volume":"101","author":"Gorovoy","year":"1983","journal-title":"Arch Ophthalmol"},{"key":"R28-20260422","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1128\/AAC.01509-15","article-title":"Biofilms of pathogenic nontuberculous mycobacteria targeted by new therapeutic approaches","volume":"60","author":"Aung","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"key":"R29-20260422","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0002-9394(14)73537-8","article-title":"Ciprofloxacin therapy of Mycobacterium chelonae keratitis","volume":"115","author":"Hwang","year":"1993","journal-title":"Am J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_3338_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:27:48Z","timestamp":1787837268000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_3338_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,14]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_3338_23","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,14]]},"assertion":[{"value":"2023-12-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}