Walkden Andrew, Fullwood Catherine, Tan Shi Zhuan, Au Leon, Armstrong Malcolm, Brahma Arun K, Chidambaram Jaya D, Carley Fiona
Cornea Department, Manchester Royal Eye Hospital, Manchester, United Kingdom.
Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
Cornea. 2018 Dec;37(12):1555-1560. doi: 10.1097/ICO.0000000000001748.
Microbial keratitis (MK) is a major cause of corneal blindness worldwide. Variations in season and temperature can affect MK incidence due to specific causative organisms; however, few studies have examined these factors in the UK.
Retrospective review of all corneal scrapes from patients with MK presenting to Manchester Royal Eye Hospital, UK, between January 2004 and December 2015. Manchester's monthly temperature data were obtained from Met Office UK. Analysis was performed using logistic regression.
From 4229 corneal scrapes, 1539 organisms grew (90.6% bacteria, 7.1% fungi, and 2.3% Acanthamoebae sp.). Gram-positive bacteria grew with increasing temperature [odds ratio (OR) 1.62, 95% CI: 1.11-2.39, P = 0.014], and fungi grew with decreasing temperature (OR 0.29, 95% CI: 0.16-0.51, P < 0.001). Moraxella sp. grew with decreasing temperature (OR 0.91, 95% CI: 0.86-0.96, P = 0.001). Compared with winter, overall culture positivity was significantly less likely in summer (OR 0.57, 95% CI: 0.38-0.87, P = 0.008) and spring (OR 0.65, 95% CI: 0.43-0.99, P = 0.045). Gram-negative bacteria were more likely in summer (OR 1.48, 95% CI: 1.06-2.09, P = 0.022) and autumn (OR 1.75, 95% CI: 1.24-2.47, P = 0.001). Candida sp. were less likely in summer (OR 0.25, 95% CI: 0.07-0.82, P = 0.027) and autumn (OR 0.18, 95% CI: 0.05-0.62, P = 0.009), and Acanthamoeba sp. were less likely in summer (OR 0.39, 95% CI: 0.15-0.92, P = 0.037) and spring (OR 0.26, 95% CI: 0.08-0.69, P = 0.011).
Herein we report variation in the incidence of MK-causing organisms by season and temperature; this finding may aid clinicians in predicting possible causative organisms for MK at differing times of the year.
微生物性角膜炎（MK）是全球角膜盲的主要病因。季节和温度的变化会因特定的致病微生物而影响MK的发病率；然而，在英国很少有研究探讨这些因素。
对2004年1月至2015年12月期间在英国曼彻斯特皇家眼科医院就诊的MK患者的所有角膜刮片进行回顾性研究。曼彻斯特的月温度数据来自英国气象局。使用逻辑回归进行分析。
在4229次角膜刮片中，培养出1539种微生物（90.6%为细菌，7.1%为真菌，2.3%为棘阿米巴属）。革兰氏阳性菌随着温度升高而生长[比值比（OR）1.62，95%置信区间：1.11 - 2.39，P = 0.014]，真菌随着温度降低而生长（OR 0.29，95%置信区间：0.16 - 0.51，P < 0.001）。莫拉克斯氏菌属随着温度降低而生长（OR 0.91，95%置信区间：0.86 - 0.96，P = 0.001）。与冬季相比，表示整体培养阳性的可能性在夏季（OR 0.57，95%置信区间：0.38 - 0.87，P = 0.008）和春季（OR 0.65，95%置信区间：0.43 - 0.99，P = 0.045）显著降低。革兰氏阴性菌在夏季（OR 1.48，95%置信区间：1.06 - 上一页2.09，P = 0.022）和秋季（OR 1.75，95%置信区间：1.24 - 2.47，P = 0.001）更常见。念珠菌属在夏季（OR 0.25，95%置信区间：0.07 - 0.82，P = 0.027）和秋季（OR 0.18，95%置信区间：0.05 - 0.62，P = 0.009）较少见，棘阿米巴属在夏季（OR 0.39，95%置信区间：0.15 - 0.92，P = 0.037）和春季（OR 0.26，95%置信区间：0.08 - 0.69，P = 0.011）较少见。
在此我们报告了引起MK的微生物发病率随季节和温度的变化；这一发现可能有助于临床医生预测一年中不同时间MK可能的致病微生物。
