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日本微生物性角膜炎的趋势。

Trends in microbial keratitis in Japan.

作者信息

Toshida Hiroshi, Kogure Nobuyuki, Inoue Naoki, Murakami Akira

机构信息

Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

Eye Contact Lens. 2007 Mar;33(2):70-3. doi: 10.1097/01.icl.0000237825.98225.ca.

Abstract

PURPOSE

To identify microbiologic characteristics of infectious keratitis and predisposing factors.

METHODS

The microorganisms isolated from patients with infectious corneal ulcers during the 5 years between January 1999 and December 2003 were retrospectively examined. Herpetic and other viral infections were excluded from this study. Patient age, sex, risk factors, and isolated organisms were collected.

RESULTS

In 123 eyes of 122 patients, organisms were isolated from 72 (58.5%) eyes. In total, 99 different organisms were isolated. Among these, 77 (77.8%) were gram-positive bacteria; 18 (18.2%) were gram-negative bacteria; six (6.1%) were fungi; and one (1.0%) was acanthamoeba. Contact lens wear was the main risk factor (54.5%), and ocular surface disease and previous ocular surgery were present in 20.5% and 13.1% of cases, respectively. Posttreatment visual acuity was significantly improved by pretreatment in culture-positive groups treated according to the antibiotic susceptibilities (Wilcoxon t test, P<0.01).

CONCLUSIONS

The results are changing to those reported by other countries and generations. Contact lens wear is the most important risk factor in Japan. The results of isolation and culture are essential for improving the cure rate.

摘要

目的

确定感染性角膜炎的微生物学特征及易感因素。

方法

回顾性研究1999年1月至2003年12月这5年间从感染性角膜溃疡患者中分离出的微生物。本研究排除疱疹及其他病毒感染。收集患者的年龄、性别、危险因素及分离出的微生物。

结果

122例患者的123只眼中,72只眼(58.5%)分离出微生物。共分离出99种不同的微生物。其中,革兰氏阳性菌77种(77.8%);革兰氏阴性菌18种(18.2%);真菌6种(6.1%);棘阿米巴1种(1.0%)。佩戴隐形眼镜是主要危险因素(54.5%),眼表疾病和既往眼部手术分别占病例的20.5%和13.1%。根据抗生素敏感性进行治疗的培养阳性组中,治疗后视力经预处理有显著改善(Wilcoxon t检验,P<0.01)。

结论

结果正在向其他国家及不同年代所报告的情况转变。在日本,佩戴隐形眼镜是最重要的危险因素。分离培养结果对于提高治愈率至关重要。

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