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印度古吉拉特邦西部角膜溃疡患者的临床微生物学研究。

A clinical microbiological study of corneal ulcer patients at western Gujarat, India.

作者信息

Somabhai Katara Rajesh, Dhanjibhai Patel Nilesh, Sinha Mala

机构信息

Department of Microbiology, B. J. Medical College, Ahmedabad, Gujarat, India.

出版信息

Acta Med Iran. 2013 Jul 13;51(6):399-403.

Abstract

Corneal ulcer is a major cause of blindness throughout the world. When the cornea is injured by foreign particles, there are chances of infection by the organism and development of ulcer. Bacterial infection in the cornea is invariably an alteration of the defense mechanism of the outer eye. It is essential to determine the local etiology within a given region when planning a corneal ulcer management strategy. Laboratory evaluation is necessary to establish the diagnosis and to guide the antibiotic therapy. One hundred corneal ulcer patients were studied by collecting their corneal scraping samples and processing at Clinical Microbiology department of Shree Meghaji Petharaj Shah Medical College, Jamnagar, Gujarat, India during a period of 17 months. All clinical microbiology laboratory procedures followed standard protocols described in the literature. 40 (40%) patients from the age group of 20-70 years had been confirmed as - any organism culture positive - within the corneal ulcer patient population. Fungi were isolated from 26 (26%) corneal ulcer patients. The bacterial etiology was confirmed in 14 (14%) corneal ulcer patients. The major risk factors for mycotic keratitis were vegetative injury (16, (62%)), followed by conjunctivitis (4, (15%)), and blunt trauma (3, (11%)). Pseudomonas aeruginosa was the most commonly isolated bacterium (6, (43%)), followed by Proteus spp. (4, (29%)). Corneal Infections due to bacteria and filamentous fungi are a frequent cause of corneal damage. Microbiological investigation is an essential tool in the diagnosis of these infections. The frequency of fungal keratitis has risen over the past 20 to 30 years. Prognosis of bacterial corneal infection has improved since the introduction of specific antibacterial therapy.

摘要

角膜溃疡是全球失明的主要原因。当角膜被异物颗粒损伤时,存在被生物体感染并发展为溃疡的可能性。角膜中的细菌感染始终是外眼防御机制的改变。在制定角膜溃疡管理策略时,确定给定区域内的局部病因至关重要。实验室评估对于确立诊断和指导抗生素治疗是必要的。在17个月的时间里,印度古吉拉特邦贾姆讷格尔市的什里·梅加吉·佩塔拉杰·沙阿医学院临床微生物学系收集了100例角膜溃疡患者的角膜刮片样本并进行处理,对这些患者进行了研究。所有临床微生物学实验室程序均遵循文献中描述的标准方案。在角膜溃疡患者群体中,年龄在20 - 70岁的40名(40%)患者被确诊为——任何生物体培养呈阳性。从26例(26%)角膜溃疡患者中分离出真菌。14例(14%)角膜溃疡患者的细菌病因得到证实。真菌性角膜炎的主要危险因素是植物性损伤(16例,(62%)),其次是结膜炎(4例,(15%))和钝挫伤(3例,(11%))。铜绿假单胞菌是最常分离出的细菌(6例,(43%)),其次是变形杆菌属(4例,(29%))。细菌和丝状真菌引起的角膜感染是角膜损伤的常见原因。微生物学调查是诊断这些感染的重要工具。在过去20至30年中,真菌性角膜炎的发病率有所上升。自从引入特异性抗菌治疗以来,细菌性角膜感染的预后有所改善。

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