Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, India.
Indian J Ophthalmol. 2011 Sep-Oct;59(5):367-71. doi: 10.4103/0301-4738.83613.
To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam.
In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire.
In 188 (60.6%) cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%). The maximum (23.4%) cases were reported during the paddy harvesting season in Assam (January and February). Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH) mount. The commonest predisposing factor was corneal injury (74.5%). While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25%) was the commonest isolate followed by Aspergillus species (19%), Curvularia species (18.5%) and Penicillium species (15.2%). Yeasts were isolated in 2.7% (n=5) cases.
Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.
研究在阿萨姆邦一家三级转诊医院治疗的真菌性角膜炎的各种危险因素和流行病学变量的相关性。
在这项基于医院的前瞻性研究中，2007 年 4 月至 2009 年 3 月期间，共有 310 名连续就诊于阿萨姆邦医学院眼科门诊的角膜溃疡患者被纳入研究。对所有疑似病例进行临床和裂隙灯生物显微镜检查后，对疑似真菌感染的病例进行涂片和培养检查以确定病因。在预先设计的问卷中记录了每个病例的人口统计学信息和相关的可能危险因素。
在 188 例（60.6%）真菌性病因明确的病例中，男性占 67.6%。最常见的发病年龄组为 41-50 岁（25.5%）。在阿萨姆邦的水稻收割季节（1 月和 2 月）报告的病例最多（23.4%）。在 65.2%的病例中，直接用氢氧化钾（KOH）载玻片可以显示真菌成分。最常见的诱发因素是角膜损伤（74.5%）。虽然糖尿病是导致 11.1%的混合细菌和真菌感染的一个重要的全身性诱发因素，但阻塞性鼻泪管是导致 11.1%病例的局部诱发因素。在分离出的真菌中，镰孢菌属（25%）最为常见，其次是曲霉菌属（19%）、弯孢菌属（18.5%）和青霉菌属（15.2%）。分离出的酵母菌占 2.7%（n=5）。
眼部创伤是阿萨姆邦真菌性角膜溃疡的最常见原因，镰孢菌属是导致这种溃疡的最常见病原体。大多数真菌性溃疡患者来自农村地区，包括茶园。
