CAUSES OF SUPPURATIVE KERATITIS IN GHANA
CAUSES OF SUPPURATIVE KERATITIS IN GHANA
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DOI：
10.1136/bjo.79.11.1024
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发表时间：
1995-11-01
影响因子：
4.1
通讯作者：
JOHNSON, G
中科院分区：
文献类型：
--
作者：
HAGAN, M;WRIGHT, E;JOHNSON, G
目的：化脓性角膜炎在所有热带国家都是一个严重问题，但关于非洲的致病生物的信息很少。目的是确定加纳南部的致病微生物和真菌引起的病例比例，并确定眼科诊所是否可以根据革兰氏染色作出正确的治疗决定。方法：从在阿克拉Korle Bu医院就诊的连续新患者的角膜溃疡处采集刮屑，接种“巧克力”和Sabouraud’s琼脂。在眼科诊所进一步取刮片进行革兰氏染色和解释。重复的载玻片由英国一位经验丰富的微生物学家评估。结果199例患者中有114例（57.3%）检出一种或多种病原菌，以镰刀菌、铜绿假单胞菌和表皮葡萄球菌最为常见。真菌，单独或联合，从56%的阳性培养患者中分离出来。总共有122名患者（61.3%）根据微生物诊断结果确定或改变了治疗方案；其中87例完全基于直接显微镜检查。结论：丝状真菌感染占溃疡培养物的一半以上。技术培训和解释经验都是必要的，以显微镜为基础的诊断在诊所工作人员是最有价值的。直接显微镜对检测真菌特别有用。
Aims-Suppurative keratitis is a serious problem in all tropical countries, but very little information is available about the causative organisms in Africa. The objectives were to identify the causative organisms and the proportion of cases caused by fungi in southerm Ghana, and to determine whether correct decisions about treatment could be made on the basis of Gram stain in the eye clinic.Methods-Scrapings were taken from corneal ulcers of consecutive new patients presenting at Korle Bu Hospital, Accra, and inoculated on 'chocolate' and Sabouraud's agars. Further scrapings were taken for Gram staining and interpretation in the eye clinic. Duplicate slides were assessed by an experienced microbiologist in the UK.Results-One or more organisms were cultured from 114 of 199 patients (57.3%), the most common being Fusarium species, Pseudomonas aeruginosa, and Staphylococcus epidermdis. Fungi, alone or in combination, were isolated from 56% of the patients who had positive cultures. In total, 122 patients (61.3%) had their treatment either determined or altered based on the results of the microbiological diagnosis; in 87 of these solely on the basis of direct microscopic examination.Conclusions-Infection by filamentous fungi accounted for more than half of the ulcers from which cultures were obtained. Both training in technique and experience in interpretation are necessary for microscopy based diagnosis by staff in the clinic to be of greatest value. Direct microscopy was particularly useful for detecting fungi.