Bhartiya Prashant, Daniell Mark, Constantinou Marios, Islam F M Amirul, Taylor Hugh R
Centre for Eye Research Australia, University of Melbourne, Mellbourne, Victoria, Australia.
Clin Exp Ophthalmol. 2007 Mar;35(2):124-30. doi: 10.1111/j.1442-9071.2006.01405.x.
Description of the clinical and microbiological spectrum of fungal keratitis at a tertiary eye care hospital in Melbourne, Australia.
Retrospective review of all patients with keratitis with positive fungal cultures from corneal or associated samples presenting to the Royal Victorian Eye and Ear Hospital, Melbourne, Australia from July 1996 to May 2004. Demographic data, predisposing factors, features on presentation, management, outcomes and microbiological data were collected and analysed.
The study included 56 eyes of 56 patients. Thirty-five patients were treated as 'typical' fungal keratitis and used for description and analysis, with a mean follow up of 18 months. Ocular trauma (37.1%), chronic steroid use (31.4%) and poor ocular surface (25.7%) were the major predisposing factors. Perforation was seen in 25.7% of patients, penetrating keratoplasty was required in 9 (25.7%) patients and evisceration was performed in 2 (5.7%) patients. Candida albicans (13 patients, 37.2%) was the most common fungal isolate accounting for more than one-third of all organisms followed by Aspergillus fumigatus (six patients, 17.1%) and Fusarium sp. (five patients, 14.3%).
The present study describes the clinical patterns of fungal keratitis in Melbourne, Australia and contrasts them with reports from other areas of the world. A high incidence of C. albicans infection and the prior use of steroids in high proportion of the patients are highlighted in this study.
对澳大利亚墨尔本一家三级眼科护理医院真菌性角膜炎的临床和微生物学谱进行描述。
回顾性分析1996年7月至2004年5月期间在澳大利亚墨尔本皇家维多利亚眼耳医院就诊的所有角膜或相关样本真菌培养阳性的角膜炎患者。收集并分析人口统计学数据、诱发因素、临床表现、治疗、结局和微生物学数据。
该研究纳入了56例患者的56只眼。35例患者被视为“典型”真菌性角膜炎并用于描述和分析，平均随访18个月。眼外伤（37.1%）、长期使用类固醇（31.4%）和眼表状况差（25.7%）是主要诱发因素。25.7%的患者出现穿孔，9例（25.7%）患者需要进行穿透性角膜移植术，2例（5.7%）患者进行了眼球摘除术。白色念珠菌（13例患者，37.2%）是最常见的真菌分离株，占所有分离菌的三分之一以上，其次是烟曲霉（6例患者，17.1%）和镰刀菌属（5例患者，14.3%）。
本研究描述了澳大利亚墨尔本真菌性角膜炎的临床模式，并将其与世界其他地区的报告进行了对比。本研究强调了白色念珠菌感染的高发病率以及高比例患者先前使用类固醇的情况。
