Satpathy Gita, Behera Himanshu Sekhar, Ahmed Nishat Hussain
Section of Ocular Microbiology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2017 Feb;65(2):97-102. doi: 10.4103/ijo.IJO_870_16.
Chlamydia trachomatis, an obligate intraocular bacteria causing trachoma, adult and neonatal inclusion conjunctivitis, was the leading cause of blindness in the last century worldwide. Improvement in socioeconomic and living conditions, availability of antibiotics, and introduction of National Trachoma Control Programmes reduced the prevalence in developed countries, but it persisted in resource-poor settings of Africa and Asia, including India. In 2016, as per the WHO report, trachoma is restricted to 42 countries, causing blindness/visual impairment in ~1.9 million people. India is one of the five countries with nearly half of total active trachoma patients. Introduction of Global Elimination of Trachoma 2020 program by the WHO, using SAFE strategy (surgery for trachomatous trichiasis; Antibiotics for C. trachomatis; Facial cleanliness; and environmental improvement) greatly reduced the prevalence, but trachoma still persists in India. Global increase in the reproductive tract infection by C. trachomatis urogenital serotypes (D-K) has led to concurrent increase in C. trachomatis eye infections. Therefore, kerato eye infections due to chlamydial infections continue to be seen in hospitals. Over the years, there have been advances in laboratory diagnostics, in understanding the pathogenesis, tissue tropism, C. trachomatis genomics, and treatment modalities. Due attention and research is still needed for the study of C. trachomatis eye infections.
沙眼衣原体是一种专性胞内细菌,可导致沙眼、成人及新生儿包涵体结膜炎,在上个世纪曾是全球失明的主要原因。社会经济和生活条件的改善、抗生素的可及性以及国家沙眼控制规划的实施,降低了发达国家的沙眼患病率,但在非洲和亚洲包括印度等资源匮乏地区,沙眼仍然存在。根据世界卫生组织2016年的报告,沙眼仅在42个国家存在,导致约190万人失明或视力受损。印度是五个沙眼活跃患者总数近占全球一半的国家之一。世界卫生组织推出的“2020年全球消除沙眼规划”,采用SAFE策略(针对沙眼性倒睫进行手术;使用抗生素治疗沙眼衣原体;保持面部清洁;改善环境卫生),极大地降低了沙眼患病率,但沙眼在印度仍然存在。沙眼衣原体泌尿生殖道血清型(D-K)在全球范围内导致的生殖道感染增加,使得沙眼衣原体眼部感染也随之增加。因此,医院中仍可见到衣原体感染导致的角膜眼部感染。多年来,在实验室诊断、对发病机制、组织嗜性、沙眼衣原体基因组学以及治疗方式的认识方面均取得了进展。然而,对于沙眼衣原体眼部感染的研究仍需给予充分关注和开展相关研究。