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刁红星. 广东地区感染性角膜溃疡病原学及相关因素分析[J]. 中山大学学报(医学科学版), 2012,33(6).
Microbial Keratitis in Guangdong Province: Microbiology and Risk Factors Study[J]. Journal of Sun Yat-sen University (Medical Sciences), 2012, 33(6).
【目的】 了解感染性角膜溃疡发病特点及病原学分布特征,为临床合理诊治提供依据。【方法】 收集中山眼科中心2004-2011年924例诊断为感染性角膜溃疡患者的临床资料,对其细菌和真菌的分布特征、发病高峰、人群特征、发病诱因等进行回顾性分析。【结果】 病原特征显示:924例患者中,389例病原菌培养阳性,其中细菌162例,真菌209例,真菌和细菌混合感染18例;细菌以表皮葡萄球菌最多,共76株(占42.22%),其次为铜绿假单胞菌,39株(占21.67%);真菌以镰刀菌属最多,共86株(占36.12%),其次为曲霉菌属和蠕孢菌属,分别为46株(占20.26%)和43株(占18.94%)。细菌中G-杆菌呈上升趋势,真菌中蠕孢菌属及毛霉菌近年呈上升趋势,而镰刀菌属近3年下降明显。流行病学特征显示:924例患者以男性居多,共611例(占66.12%),发病年龄以40 ~ 60岁为主,共431例(占46.65%),职业主要是农民,有512例(占55.41%),10 ~ 12月为高发季节,外伤是主要诱因。【结论】 广东地区感染性角膜溃疡患者以中老年男性农民为主,其发病与农业活动密切相关,主要致病细菌为表皮葡萄球菌,真菌为镰刀菌属。
【Objective】 To study the profile of microbial keratitis in Guangdong province with special focus on clinical presentations and causative organisms. 【Methods】 A retrospective analysis of all patients admitted in Zhongshan Ophthalmic Center over a period of 8 years from 2004 to 2011 was performed. A total of 924 patients with microbial corneal ulcer were analyzed. Data collected from medical records were demographic features, predisposing factors, and causative organism. 【Results】 Out of 924 patients, 389 were positive cultures. Of those individuals with positive cultures, 162 had pure bacterial infection, 209 had pure fungal infection and 18 had mixed growth. The most common causative bacteria isolated was Staphylococcus epidermidis (76,42.44%), followed by pseudomonas aeroginosa (39, 21.67%); The most common causative fungus isolated was Fusarium sp.(86,36.12%), followed by Aspergillus sp. (46,20.26%) and Helminthosporium sp. (43,18.94%). Compared to the past study in Zhongshan Ophthalmic Center, the percentage of gram negative bacilli in bacteria and Helminthosporium sp. and Aspergillus sp.in fungus were rising, and the percentage of Fusarium sp.was declining in recently 3 year. Of all individuals, 611(66.12%) were male patients and a peak incidence age from 40 to 60 years old (46.65%).Most of the patients were peasant (512, 55.41%) and the peak incidence season was from October to December. The ocular trauma was the most commonly identified predisposing factor. 【Conclusion】 The peasant of the middle age and elderly represented a distinct clinical group in the context of microbial keratitis in Guangdong province. Ocular trauma in agriculture were the major predisposing factors. The most common causative organisms were Staphylococcus epidermidis in bacteria and Fusarium sp. in fungus.
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