Epidemiological characteristics, predisposing factors and microbiological profiles of infectious corneal ulcers: the Portsmouth corneal ulcer study
Epidemiological characteristics, predisposing factors and microbiological profiles of infectious corneal ulcers: the Portsmouth corneal ulcer study
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DOI：
10.1136/bjo.2008.151167
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发表时间：
2009-10-01
影响因子：
4.1
通讯作者：
Cree, I. A.
中科院分区：
文献类型：
--
作者：
Ibrahim, Y. W.;Boase, D. L.;Cree, I. A.
目的：了解英格兰南部人群感染性角膜溃疡的流行病学特征、易感因素及临床和微生物学诊断。方法：对1997年1月至2003年12月在英国朴茨茅斯亚历山德拉女王医院眼科就诊的感染性角膜溃疡患者进行回顾性分析。结果：共有1786例患者出现感染性角膜溃疡，平均年龄45岁，女性占54.5%。配戴隐形眼镜是554例(31%)患者的主要诱因。在800例患者中，1254例患者的角膜刮片培养阳性。979株细菌中革兰阳性菌696株(71.1%)，革兰阴性菌283株(28.9%)，以铜绿假单胞菌为主。在11名棘阿米巴角膜炎患者中，有9名戴隐形眼镜。大多数患者1728例(96.8%)多次寻求医疗帮助，34例(1.9%)视力结果较差。随访1633例(91.4%)，平均11.5天。结论：配戴隐形眼镜仍是感染性角膜溃疡最重要的危险因素。减少感染性角膜炎的发生率和严重程度需要对患者和专业人员进行持续的教育。
Aim: The aim of the study was to identify the epidemiological characteristics, predisposing factors, and the clinical and microbiological diagnosis of infectious corneal ulcers in a population based in southern England.Methods: A retrospective review was undertaken of the medical records of patients presenting with infectious corneal ulcers at the eye casualty department of Queen Alexandra Hospital, Portsmouth, UK, between January 1997 and December 2003.Results: A total of 1786 patients presented with infectious corneal ulcers, with a mean age of 45 years and female predominance (54.5%). Contact lens wear was the main predisposing factor in 554 patients (31%). Corneal scrapes from 1254 patients grew positive cultures in 800 patients. Gram-positive bacteria accounted for 696 (71.1%) of the total 979 bacterial isolates, while Gram-negative bacteria accounted for 283 (28.9%) with the predominance of Pseudomonas aeruginosa. Nine out of 11 patients with Acanthamoeba keratitis were contact lens wearers. The majority of patients 1728 (96.8%) sought medical help more than once and 34 patients (1.9%) had poor visual outcome. Follow-up was completed in 1633 patients (91.4%) with an average of 11.5 days.Conclusions: Wearing contact lenses remains the most important risk factor for infectious corneal ulcers. Reduction of the rate and severity of infectious keratitis requires continuous education of patients, and of professionals.