埃塞俄比亚亚的斯亚贝巴米尼利克二世纪念医院角膜溃疡患者的真菌性角膜炎
Fungal keratitis in patients with corneal ulcer attending Minilik II Memorial Hospital, Addis Ababa, Ethiopia.
作者信息
Kibret Tihtina, Bitew Adane
机构信息
Department of Medical Laboratory Sciences, Tirunesh Beijing Hospital, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
BMC Ophthalmol. 2016 Aug 30;16(1):148. doi: 10.1186/s12886-016-0330-1.
BACKGROUND
Fungal keratitis is an important cause of corneal blindness all over the world. Although there are several reports on fungal keratitis from developing and developed countries, fungal keratitis in Ethiopia is poorly known. The aim of this study was to determine the prevalence of fungal keratitis and spectrum of fungi implicated in causing the infection.
METHODS
The present study was a single institutional cross-sectional study carried out in Minilik II Memorial Hospital eye clinic, Addis Ababa, Ethiopia from September 2014 to August 2015. Corneal scraping was obtained under aseptic condition with sterile 21 gauge needle by an ophthalmologist from patients suspected of microbial keratitis. Each scraping was inoculated onto Sabouraud Dextrose Agar in C-shaped streaks and incubated at 25 °C aerobically for four weeks. Cultures of mycelia fungi were identified by examining macroscopic and microscopic characteristics of their colonies. Yeasts were identified by employing biochemical and assimilation test procedures and using CHROMagar Candida culture. All data were coded, double entered and analyzed using SPSS version 20.
RESULT
Out of 153 cases of microbial keratitis, fungi were recovered from 69 patients giving fungal keratitis prevalence of 45.1. Patients from rural areas were significantly affected than patients in urban regions (P = 0.005). Age groups of 25-34 (P = 0.017) and 15-24 years (P = 0.008) were significantly affected. Fungal keratitis was significantly associated with farmers (P = 0.0001), daily laborers (P = 0.0001), unemployed (P = 0001) and students (P = 0.004). Fungal keratitis was statistically associated with trauma (P = 0.006), and diabetes (P = 0.024). Seventy six fungal isolates were recovered, of which molds accounted 63 (82.9 %) of the total isolates. Fusarium and Aspergillus species were the two predominant molds accounting 27.6 and 25 % of the total isolates respectively. Yeast isolates accounted only 17.1 %.
CONCLUSION
High prevalence of fungal keratitis recorded in the present study, highlights the need for nationwide study on fungal keratitis and precise identification of the causative fungi and institution of appropriate treatment strategy.
背景
真菌性角膜炎是全球角膜盲的一个重要原因。尽管发展中国家和发达国家都有关于真菌性角膜炎的若干报道，但埃塞俄比亚的真菌性角膜炎却鲜为人知。本研究的目的是确定真菌性角膜炎的患病率以及引起感染的真菌种类。
方法
本研究是一项单机构横断面研究，于2014年9月至2015年8月在埃塞俄比亚亚的斯亚贝巴的米尼利克二世纪念医院眼科诊所进行。眼科医生在无菌条件下用无菌21号针头从疑似微生物性角膜炎的患者处获取角膜刮片。将每个刮片以C形条纹接种到沙氏葡萄糖琼脂上，在25℃有氧条件下培养四周。通过检查菌丝真菌菌落的宏观和微观特征来鉴定菌丝真菌。通过采用生化和同化试验程序并使用科玛嘉念珠菌培养基来鉴定酵母。所有数据进行编码、双录入，并使用SPSS 20版进行分析。
结果
在153例微生物性角膜炎病例中，从69例患者中分离出真菌，真菌性角膜炎患病率为45.1%。农村地区的患者比城市地区的患者受影响更显著（P = 0.005）。25 - 34岁年龄组（P = 0.017）和15 - 24岁年龄组（P = 0.008）受影响更显著。真菌性角膜炎与农民（P = 0.0001）、日工（P = 0.0001）、失业者（P = 0.0001）和学生（P = 0.004）显著相关。真菌性角膜炎与外伤（P = 0.006）和糖尿病（P = 0.024）在统计学上相关。共分离出76株真菌，其中霉菌占分离株总数的63株（82.9%）。镰刀菌属和曲霉属是两种主要的霉菌，分别占分离株总数的27.6%和25%。酵母分离株仅占17.1%。
结论
本研究记录的真菌性角膜炎高患病率凸显了在全国范围内开展真菌性角膜炎研究、精确鉴定致病真菌并制定适当治疗策略的必要性。
Zotero 插件