Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade.
Review of epidemiological features, microbiological diagnosis and treatment outcome of microbial keratitis: experience of over a decade.
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DOI：
10.4103/0301-4738.53051
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发表时间：
2009-07
影响因子：
3.1
通讯作者：
Rao GN
中科院分区：
文献类型：
--
作者：
Gopinathan U;Sharma S;Garg P;Rao GN
回顾疑似微生物性角膜炎患者的流行病学特征、微生物学特征和治疗结果。对数据库中的非比较系列进行了回顾性分析。所有出现角膜基质浸润的患者都接受了标准的角膜刮片微生物学评价，涂片和培养指导的抗菌治疗。在5897例疑似微生物性角膜炎病例中，3563例（60.4%）经培养证实（细菌- 1849例，51.9%;真菌- 1360例，38.2%;阿米巴- 86例，2.4%;混合型- 268例，7.5%）。从事农业活动的患者发生微生物性角膜炎的风险高1.33倍（CI 1.16-1.51），眼外伤患者发生微生物性角膜炎的风险高5.33倍（CI 6.41-6.44）。氢氧化钾荧光白色染色法检测角膜刮片中真菌和阿米巴的敏感性最高，分别为90.6%和84.0%，而革兰氏染色法检测细菌的敏感性较低，仅为56.6%。细菌感染以表皮葡萄球菌为主（42.3%），真菌感染以镰刀菌为主（36.6%）。与细菌性角膜炎（799/1849，43.2%）和阿米巴角膜炎（15/86，17.4%）相比，真菌性角膜炎患者（691/1360，50.8%）需要手术干预的人数显著更多。细菌性角膜炎、真菌性角膜炎和阿米巴性角膜炎的角膜瘢痕愈合率分别为75.5%、64.8%和90.0%。虽然诊断和治疗方式都很好，但真菌性角膜炎的最终结局并不理想。随着对细菌性和阿米巴角膜炎的更有效治疗，真菌性角膜炎的治疗确实是一个挑战。
To review the epidemiological characteristics, microbiological profile, and treatment outcome of patients with suspected microbial keratitis. Retrospective analysis of a non-comparative series from the database was done. All the patients presenting with corneal stromal infiltrate underwent standard microbiologic evaluation of their corneal scrapings, and smear and culture-guided antimicrobial therapy. Out of 5897 suspected cases of microbial keratitis 3563 (60.4%) were culture-proven (bacterial – 1849, 51.9%; fungal – 1360, 38.2%; Acanthamoeba – 86, 2.4%; mixed – 268, 7.5%). Patients with agriculture-based activities were at 1.33 times (CI 1.16–1.51) greater risk of developing microbial keratitis and patients with ocular trauma were 5.33 times (CI 6.41–6.44) more likely to develop microbial keratitis. Potassium hydroxide with calcofluor white was most sensitive for detecting fungi (90.6%) and Acanthamoeba (84.0%) in corneal scrapings, however, Gram stain had a low sensitivity of 56.6% in detection of bacteria. Majority of the bacterial infections were caused by Staphylococcus epidermidis (42.3%) and Fusarium species (36.6%) was the leading cause of fungal infections. A significantly larger number of patients (691/1360, 50.8%) with fungal keratitis required surgical intervention compared to bacterial (799/1849, 43.2%) and Acanthamoeba (15/86, 17.4%) keratitis. Corneal healed scar was achieved in 75.5%, 64.8%, and 90.0% of patients with bacterial, fungal, and Acanthamoeba keratitis respectively. While diagnostic and treatment modalities are well in place the final outcome is suboptimal in fungal keratitis. With more effective treatment available for bacterial and Acanthamoeba keratitis, the treatment of fungal keratitis is truly a challenge.
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DOI：
10.1111/j.1442-9071.1989.tb00564.x
发表时间：
1989-11-01
期刊：
AUSTRALIAN AND NEW ZEALAND JOURNAL OF OPHTHALMOLOGY
影响因子：
--
作者：
MCCLELLAN, KA;BERNARD, PJ;BILLSON, FA
通讯作者：
BILLSON, FA
影响因子：
4.1
作者：
Kunimoto, DY;Sharma, S;Rao, GN
通讯作者：
Rao, GN
影响因子：
--
作者：
ERIE, JC;NEVITT, MP;BALLARD, D
通讯作者：
BALLARD, D
影响因子：
--
作者：
ASBELL, P;STENSON, S
通讯作者：
STENSON, S
影响因子：
4.1
作者：
HAGAN, M;WRIGHT, E;JOHNSON, G
通讯作者：
JOHNSON, G