Inoue Naoki, Toshida Hiroshi, Mamada Naoki, Kogure Nobuyuki, Murakami Akira
Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
Eye Contact Lens. 2007 Mar;33(2):65-9. doi: 10.1097/01.icl.0000233869.21964.1b.
To identify microbiologic characteristics of infectious keratitis associated with contact lenses.
The authors retrospectively examined the microorganism isolated from patients with microbial corneal ulcer associated with contact lenses during a 5-year period. Herpetic and other viral infections were excluded from this study. Patient age, sex, type of contact lens, and isolated organisms were collected from medical records.
Sixty-seven eyes of 66 patients (54.5%) who possibly had contact lens-induced infectious keratitis were reviewed. Cultures of corneal scrapings or eye discharge were positive in 30 (44.8%) of 67 eyes. A total of 35 strains of bacteria were detected, among which there were 29 (82.9%) gram-positive bacteria, two (5.7%) gram-negative bacteria, three (8.6%) fungi, and one (2.9%) species of Acanthamoeba. The most common type of contact lens was a conventional soft contact lens (25 eyes, including extended wear in seven eyes), whereas hard contact lenses, including rigid gas-permeable contact lenses, were worn in 19 eyes. In addition, frequent-replacement lenses were used in 17 eyes, whereas weekly lenses and daily lenses were used for three eyes each. The largest age group was the 20s for all types of lenses.
The results of isolation and culture are essential for improving the cure rate, especially for patients who have severe corneal ulcers.
确定与隐形眼镜相关的感染性角膜炎的微生物学特征。
作者回顾性研究了5年间从与隐形眼镜相关的微生物性角膜溃疡患者中分离出的微生物。本研究排除了疱疹及其他病毒感染。从病历中收集患者的年龄、性别、隐形眼镜类型及分离出的微生物。
对66例可能患有隐形眼镜诱发的感染性角膜炎患者的67只眼进行了评估。67只眼中30只（44.8%）角膜刮片或眼分泌物培养呈阳性。共检测到35株细菌，其中革兰氏阳性菌29株（82.9%），革兰氏阴性菌2株（5.7%），真菌3株（8.6%），棘阿米巴1株（2.9%）。最常见的隐形眼镜类型为传统软性隐形眼镜（25只眼，包括7只长戴型），而硬性隐形眼镜，包括透气性硬性隐形眼镜，共19只眼佩戴。此外，17只眼使用频繁更换型镜片，3只眼使用周抛型镜片，3只眼使用日抛型镜片。所有类型镜片佩戴者中最大年龄组为20多岁。
分离培养结果对于提高治愈率至关重要，尤其是对于患有严重角膜溃疡的患者。
