[Aetiology analyses of 334 cases fungal keratitis].

OBJECTIVE

To analyze the distribution of pathogenic bacterium of the fungal keratitis patients for providing the data of clinical diagnosis and treatment.

METHODS

From July 2005 to December 2010 in Shandong Eye Hospital there were 352 smears of corneal ulcers and corneal tissue exemplar removed in surgery from fungal keratitis patients. The all exemplars were cultured with the Sabouraud dextrose agar culture media in 28°C under the humidor for 7 days. The strains was identified according to the appearance of fungal colonies, mycelium, spore shape, spore arrangement and fungal shape. And there did the retrospective analyses about the positive rate of fungal culture, genus distribution, seasonal distribution and sources of patients, sex ratio, age distribution and occupation. etc.

RESULTS

There were 334 stock positive fungal culture in 352 cultured specimens from fungal corneal ulcers, the positive rate was 94.9%. There were 187 positive culture from 203 corneal scraping exemplars, the positive rate was 92.1%; there were 147 positive culture from 149 corneal tissue removed in surgery, the positive rate was 98.7%. The Fusarium strains was most common in all isolated strain, 211 (63.2%). The Aspergillus was secondly 47 (14.1%). The character of seasonal distribution of culture positive strain: the 48 strains (14.4%) were cultivated from January to March; the 48 strains (14.4%) were cultivated from April to June; the 64 strains were cultivated (19.2%) from July to September; the 174 strains (52.0%) were cultured from October to December, the ratio were 1:1:1.3:3.6 quarterly (χ(2) = 3.360, P = 0.339). The incidence of fungal keratitis were higher in the autumn and winter than in spring and summer. The ratio of the male and the female was 2.04:1 in 334 culture-positive patients; the mean age was (48 ± 22) years old. The 217(65%) came from farmer in the developed group, and the other 117 cases came from other occupations (35%). The 289 (87%) cases came from Shandong Province in 334 positive patients, the 45 cases (13%) came from other province of Province. Chi-square test method was used to analysis the differences of incidence of fungal keratitis among the four seasons using SPSS11.5.

CONCLUSIONS

The Fusarium is the most important pathogen in fungal keratitis in Shandong Province. The high positive culture rate of fungal keratitis specimens plays an important role in clinical diagnosis and treatment.