Williams G, McClellan K, Billson F
Microbiology Unit, Liverpool Hospital.
Int Ophthalmol. 1991 Mar;15(2):131-5. doi: 10.1007/BF00224467.
External eye disease which result in corneal scarring are an important cause of blindness in Bangladesh and at the Chittagong Eye Infirmary and Training Complex (EITC) over 200 cases of suppurative keratitis are managed each year. We reviewed the records of 127 cases of microbial keratitis to determine the relative contributions of Gram stain and culture to diagnosis of the causative organism. There were 107 culture-proven cases of microbial keratitis amongst the 127 patients in this study. Gram stain was positive in 89 cases which represents 70% of the total and 83% of all culture-proven cases. Streptococcus pneumoniae and Pseudomonas sp were the commonest bacteria isolated and Aspergillus sp and Fusarium sp the commonest fungi. In 20 cases (16%) no organism was isolated on Gram stain or culture. Our results support the use of both Gram stain and culture in isolation of the causative organism in cases of suppurative keratitis in Bangladesh. However the low cost of Gram stain and its useful recovery rates for both bacteria and fungi support its use as an initial investigation for microbial keratitis at the secondary level of eye care in rural Bangladesh.
导致角膜瘢痕形成的外眼疾病是孟加拉国失明的一个重要原因，在吉大港眼科医院及培训中心（EITC），每年要处理200多例化脓性角膜炎病例。我们回顾了127例微生物性角膜炎病例的记录，以确定革兰氏染色和培养对致病微生物诊断的相对作用。本研究的127例患者中有107例经培养证实为微生物性角膜炎。革兰氏染色阳性的有89例，占总数的70%，占所有经培养证实病例的83%。肺炎链球菌和假单胞菌属是最常分离出的细菌，曲霉菌属和镰刀菌属是最常分离出的真菌。20例（16%）在革兰氏染色或培养中未分离出微生物。我们的结果支持在孟加拉国化脓性角膜炎病例中同时使用革兰氏染色和培养来分离致病微生物。然而，革兰氏染色成本低，对细菌和真菌的检出率都很高，这支持将其作为孟加拉国农村二级眼保健中微生物性角膜炎的初步检查方法。
