Changing Referral Patterns of Infectious Corneal Ulcers to a Tertiary Care Facility in South India-7-year analysis
Changing Referral Patterns of Infectious Corneal Ulcers to a Tertiary Care Facility in South India-7-year analysis
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DOI：
10.3109/09286586.2012.690492
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发表时间：
2012-10-01
影响因子：
1.8
通讯作者：
Vaitilingam, Manivasagam C.
中科院分区：
文献类型：
--
作者：
Sengupta, Sabyasachi;Thiruvengadakrishnan, Krishnan;Vaitilingam, Manivasagam C.
目的：为了报告转介模式的变化趋势，证明了从三级眼科医院在印度南部的实验室结果培养阳性的情况下，微生物角膜炎在南India.Methods：所有患者提出与微生物（非病毒性）角膜炎的角膜服务的Aravind眼科医院从2003年至2009年确定从计算机化的数据库。微生物学特征进行了记录，并在7年的研究period.Results的病原体的年度分布进行了比较：出了3059例假定的微生物性角膜炎，1756阳性培养（57.4%）。在培养阳性的病例中，1224例（70%）分离出真菌病原体，488例（27.7%）显示细菌生长，18例（1.03%）生长棘阿米巴，26例（1.5%）显示细菌和真菌混合生长。在研究期间，真菌分离株在培养阳性病例中的百分比从2004年的59%逐渐增加到2009年的78%。真菌性角膜炎发生率的增加具有统计学显著性（P = 0.023）。细菌分离株的数量呈比例下降趋势，从2003-2005年的31%下降到2009年的22%（P = 0.04）。细菌性角膜炎呈下降趋势。这一令人不安的趋势可能导致发展中国家角膜失明发病率的增加，因此需要进一步研究。
Purpose: To report changing trends in referral patterns of microbial keratitis evidenced by laboratory results of culture-positive cases from a tertiary eye-care hospital in south India.Methods: All patients presenting with microbial (nonviral) keratitis to the cornea services of Aravind Eye Hospital from 2003 to 2009 were identified from a computerized database. Microbiologic characteristics were recorded and annual distributions of causative organisms over the 7-year study period were compared.Results: Out of a total of 3059 cases of presumed microbial keratitis, 1756 had positive cultures (57.4%). Among the culture-positive cases, fungal pathogens were isolated from 1224 cases (70%), 488 (27.7%) showed bacterial growth, 18 (1.03%) grew acanthamoeba species and 26 (1.5%) demonstrated mixed bacterial and fungal growth. The percentage of fungal isolates in culture-positive cases increased gradually over the study period from 59% in 2004 to 78% in 2009. This increase in frequency of fungal keratitis was statistically significant (P = 0.023). A proportionally decreasing trend was seen in the number of bacterial isolates ranging from 31% in 2003-2005 to 22% in 2009 (P = 0.04).Conclusions: An incremental increase was seen in the number of fungal keratitis cases referred to our institute during the study period. Bacterial keratitis showed a decline. This disconcerting trend may lead to an increase in the incidence of corneal blindness in the developing world and thus warrants further research.