Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America
Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America
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DOI：
10.1038/sj.eye.6700151
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发表时间：
2002-09-01
期刊：
影响因子：
3.9
通讯作者：
Wong, E
中科院分区：
文献类型：
--
作者：
Lam, DSC;Houang, E;Wong, E
目的探讨香港地区微生物性角膜炎（MK）的发病率、病因和危险因素。方法对223例新确诊的MK患者进行为期17个月的综合性微生物学研究。一个巢式病例对照研究进行配戴隐形眼镜（CLW）的患者，以确定MK的危险因素，关于CLW和卫生practice.Results的类型招募的223例患者中，59（26%）戴隐形眼镜。77例患者的角膜刮片培养阳性（35%，56例非CLW，21例CLW）。共招募206名CLW志愿者参与病例对照研究，其中135名与45名CLW患者匹配。MK的年发病率为0.63/10000人群和3.4/10000 CLW，日戴、长期和硬性透镜配戴率分别为3.09、9.30和0.44/10000 CLW。铜绿假单胞菌为主要致病菌。发生了6例阿米巴角膜炎，5例在CLW中（发生率为0.33/10000 CLW），1例在角膜擦伤后。非CLW开发MK的高峰年龄为73岁，这是10年，比苏格兰和美国的预期年轻。结论以前的眼表疾病和外伤是MK在香港的主要危险因素。CLW似乎至少和在苏格兰和美国发现的一样安全。发现了阿米巴角膜炎，但发病率比苏格兰低五倍。具有统计学显著性的水凝胶CLW易患MK的因素包括过夜佩戴、卫生状况差和吸烟。
Purpose To establish the incidence, etiology and risk factors for microbial keratitis (MK) in Hong Kong.Methods Two hundred and twenty-three new cases of presumed MK were recruited over a period of 17 months and comprehensive microbiologic studies performed. A nested case-control study was pursued for patients wearing contact lenses (CLW) to determine risk factors for MK with regards to types of CLW and hygiene practice.Results Of the 223 patients recruited, 59 (26%) wore contact lenses. Corneal scrapes yielded positive cultures from 77 patients (35% overall, 56 non-CLW, 21 CLW). Two hundred and six CLW volunteers were recruited to participate in the case-control study, of whom 135 were matched with 45 CLW patients. The annual incidence of MK was 0.63 per 10 000 population and 3.4 per 10 000 CLW with rates for daily, extended and rigid lens wear of 3.09, 9.30 and 0.44 per 10 000 CLW respectively. Pseudomonas aeruginosa was the dominant bacterial pathogen. Six cases of Acanthamoeba keratitis occurred, five in CLW (incidence 0.33 per 10 000 CLW) and one following corneal abrasion. Non-CLW developed MK at a peak age of 73, which is 10 years younger than expected for Scotland and USA.Conclusions Previous ocular surface disease and trauma were the main risk factors for MK in Hong Kong. CLW appears at least as safe as that found in Scotland and the USA. Acanthamoeba keratitis was detected but with an incidence rate five times lower than Scotland. Factors predisposing hydrogel CLWs to MK, that were statistically significant, included overnight wear, poor hygiene and smoking.