温州某医院258例真菌性角膜炎诊疗分析

doi:10.3760/cma.j.cn115909-20200408-00142

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Abstract Objective: To analyze the etiology, drug sensitivity, laboratory examinations and treatment of patients with fungal keratitis in a hospital in Wenzhou, thus providing evidence for the diagnosis and prognosis of fungal keratitis. Methods: This was a retrospective case. Data from 258 patients (258 eyes) who were diagnosed with fungal keratitis at the Eye Hospital,Wenzhou Medical University, from January 2017 to December 2019 were collected. Patients were divided into different groups: Males and females, older and younger patients, farmers and non-farmers, plant injuries and non-plant injuries, fusarium and non-fusarium infections. The respective operation rates were calculated for gender, age, occupation, pathogenic factors and pathogenic bacteria. χ2 analysis was performed for the difference in operation rates in each group. Further, the positive detection rate of the pathogenic examination method was compared and analyzed, and the drug sensitivity of the main pathogenic bacteria was also included. Results: September to November was the highest incidence period for fungal keratitis, accounting for 48.1% for the entire year. Most of the patients (60.5%) were farmers. Plant injury was the leading pathogenic factor while fusarium was the main pathogen accounting for 34.5% and 45.3%, respectively. The positive rate of fungal culture was 68.6%, which was higher than the smear test (χ2 =4.522, P=0.033). Of the 258 patients with fungal keratitis, 44(17.0%) underwent surgery. Further analysis revealed that elderly (≥65 years) patients (χ2 =5.293, P=0.036), plant injury patients (χ2 =11.386, P=0.001), and fusarium infection patients (χ2 =3.939, P=0.044) had a higher probability of surgery. Additionally, the geometric mean values of the minimum inhibitory concentrations (MIC) of fusarium to amphotericin B, itraconazole and voriconazole were 4.283, 17.290 and 1.105 μg/ml, respectively; those of aspergillus were 3.389, 2.661 and 0.125 μg/ml, respectively; those of alternaria were 0.604, 0.531 and 0.258 μg/ml, respectively; and those of candida were 0.317, 0.552 and 0.047 μg/ml. Conclusions: Fusarium is the main pathogen of fungal keratitis in Wenzhou, and plant injury is the main pathogenic factor. Elderly patients, plant injuries, and fungal keratitis caused by fusarium infections are more serious and are more likely to require surgical treatment.

Key words： Wenzhou fungal keratitis etiology drug sensitivity test diagnosis and treatment

Received: 08 April 2020

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Corresponding Authors: Meiqin Zheng, Department of Clinical Laboratory, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China (Email: zmq@eye.ac.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200408-00142 OR https://www.cjoovs.com/EN/Y2020/V22/I12/928

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