Molecular Epidemiology of Infectious Corneal Ulcers at Tertiary Eye Centres in North Central Nigeria

Infectious corneal ulcer is a sight-threatening ophthalmic emergency whose causative organism profile and antimicrobial resistance patterns critically determine optimal management. In North Central Nigeria, updated molecular epidemiological data are lacking, leaving treatment protocols reliant on outdated or imported evidence. This study characterises the molecular epidemiology of infectious corneal ulcers presenting at tertiary eye centres in North Central Nigeria, specifically at Jos University Teaching Hospital and Benue State University Teaching Hospital. A prospective laboratory-based study will be conducted over 12 months. Corneal scraping samples from all presenting cases will undergo Gram stain, standard bacterial and fungal culture, and antimicrobial sensitivity testing. For microbiologically confirmed cases, polymerase chain reaction (PCR) will be used to identify viral aetiologies including herpes simplex virus. Minimum inhibitory concentrations for key antimicrobial agents will be determined to characterise resistance profiles. Descriptive statistics and logistic regression will identify clinical predictors of specific organism categories. Agricultural environments of North Central Nigeria are expected to drive high rates of fungal keratitis compared to purely urban settings, and multi-drug resistant bacterial isolates are anticipated given widespread antibiotic self-prescribing. This study generates evidence that will directly inform the revision of empirical treatment protocols for corneal ulcer at both participating hospitals and the Federal Ministry of Health. Recommendations will target antimicrobial stewardship initiatives, laboratory capacity investment for corneal microbiology, and production of locally relevant clinical management guidelines. Keywords: corneal ulcer, microbiology, molecular epidemiology, antimicrobial resistance, North Central Nigeria