Causative organisms in microbial keratitis, their sensitivity pattern and treatment outcome in western Nepal
Causative organisms in microbial keratitis, their sensitivity pattern and treatment outcome in western Nepal
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DOI：
10.3126/nepjoph.v4i1.5863
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发表时间：
2012-01-01
影响因子：
0.3
通讯作者：
Rai, (K C) S.
中科院分区：
文献类型：
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作者：
Dhakhwa, K.;Sharma, M. K.;Rai, (K C) S.
在发展中国家，角膜感染是单眼失明的主要原因之一。目的：了解细菌性角膜炎的流行病学特点、易感因素、微生物学模式、敏感性模式及治疗结果。材料与方法：回顾性分析414例确诊为感染性角膜炎的住院记录。观察指标为微生物分离物及其对治疗剂的敏感性和治疗结果。结果：312例（75.4%）为农民，138例（33.3%）有眼外伤史，17例（4.1%）使用外用皮质类固醇。138例外伤性角膜溃疡患者中，52例（37.68%）有真菌分离（RR=0.54, 95% CI = 0.44 ~ 0.68）， 32例（23.19%）有细菌生长。培养阳性300例（72.5%），其中纯真菌感染138例（33.3%），纯细菌感染121例（29.2%），混合感染41例（9.9%）。镰刀菌是最常见的真菌病原体，表皮葡萄球菌是最常见的细菌分离物。对革兰氏阳性菌最敏感的抗生素为头孢唑啉（84.92%），对革兰氏阴性菌最敏感的抗生素为环丙沙星和氧氟沙星（79.31%）。414例角膜溃疡中，363例（87.7%）完全愈合。结论：细菌性角膜炎多见于本地区农民。镰刀菌和表皮葡萄球菌是最常见的分离株。头孢唑啉和氧氟沙星分别是革兰氏阳性菌和革兰氏阴性菌最有效的抗生素。
Introduction: Corneal infection is one of the major causes of monocular blindness in developing countries.Objective: To determine the epidemiological characteristics, predisposing factors, microbiological pattern, sensitivity pattern and treatment outcome of microbial keratitis.Materials and methods: A retrospective analysis of hospital records of 414 patients with diagnosed infective keratitis was done. The outcome measures were microbial isolates, their sensitivity to therapeutic agents and treatment outcome.Results: Of the total, 312 (75.4 %) patients were farmers by profession, 138 (33.3 %) had a history of ocular trauma and 17(4.1 %) were using topical corticosteroids. Among the 138 cases of the corneal ulcer with trauma, 52 (37.68 %) had fungi isolated in culture (RR=0.54, 95% CI = 0.44 - 0.68) and 32 (23.19 %) had a bacterial growth. Cultures were positive in 300 (72.5 %) cases, having 138 (33.3 %) patients with pure fungal infection, 121 (29.2 %) with pure bacterial and 41 (9.9 %) with mixed infection. Fusarium spp was the most common fungal pathogen while Staphylococcus epidermidis was the commonest bacterial isolate. The most sensitive antibiotics for the Gram positive bacteria was cephazolin (84.92 %), while for Gram negative, ciprofloxacin and ofloxacin were the most effective (79.31 %). Of 414 cases of corneal ulcers, 363 (87.7 %) cases healed completely.Conclusion: Microbial keratitis is mostly seen in farmers in this part of the world. Fusarium and Staphylococcus epidermidis were the most common isolates. Cephazoline and ofloxacin were the most effective antibiotics for Gram positive and Gram negative organisms respectively.