Mustikka Minna P, Grönthal Thomas S C, Pietilä Elina M
Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland.
Vet Ophthalmol. 2020 Jan;23(1):148-159. doi: 10.1111/vop.12701. Epub 2019 Jul 31.
To retrospectively describe laboratory findings, treatment, and outcome associated with equine infectious keratitis in Finland.
Medical records of horses diagnosed with infectious keratitis in University of Helsinki Equine Hospital from January 2007 to June 2018 were reviewed.
Forty-seven cases were included. Keratomycosis was diagnosed in 27 eyes and bacterial keratitis in 20 eyes. Aspergillus flavus was the most frequent fungal isolate (9/17, 53%), followed by Cylindrocarpon sp. (3/17, 18%) and Aspergillus fumigatus (2/17, 12%). Susceptibility was tested for 10/11 Aspergillus sp. isolates; all were susceptible to voriconazole while only two were susceptible to amphotericin B. Cylindrocarpon sp. isolates were resistant to both agents. Streptococcus equi subsp. zooepidemicus was the most frequent bacterial isolate (9/19, 47%), followed by other streptococci (4/19, 21%). All 13 Streptococcus sp. isolates were susceptible to penicillin, and all tested isolates (n = 11) were also susceptible to chloramphenicol. Mean duration of medical treatment was longer in fungal keratitis (38 days) than in bacterial keratitis (25 days) (P < .001). Twenty-six of the eyes underwent globe-sparing surgery in addition to medical therapy. Recovery was achieved in 66% (31/47) of all cases and in 59% (16/27) and 75% (15/20) (P = .264) of cases with keratomycosis and bacterial keratitis, respectively.
Although Aspergillus sp. and S zooepidemicus were the most frequently encountered isolates, cytology, culture, and susceptibility testing are essential to differentiate bacterial and fungal keratitis and guide the clinician to choose the most efficient treatment.
回顾性描述芬兰马传染性角膜炎的实验室检查结果、治疗方法及预后情况。
回顾了2007年1月至2018年6月在赫尔辛基大学马医院被诊断为传染性角膜炎的马匹的病历。
共纳入47例病例。27只眼诊断为角膜真菌病，20只眼诊断为细菌性角膜炎。黄曲霉是最常见的真菌分离株（9/17，53%），其次是柱孢属（3/17，18%）和烟曲霉（2/17，12%）。对10/11株曲霉菌分离株进行了药敏试验；所有分离株对伏立康唑敏感，而只有两株对两性霉素B敏感。柱孢属分离株对这两种药物均耐药。马链球菌兽疫亚种是最常见的细菌分离株（9/19，47%），其次是其他链球菌（4/19，21%）。所有13株链球菌分离株对青霉素敏感，所有受试分离株（n = 11）对氯霉素也敏感。真菌性角膜炎的平均药物治疗时间（38天）比细菌性角膜炎（25天）长（P <.001）。除药物治疗外，26只眼还接受了保眼球手术。所有病例中有66%（31/47）恢复，角膜真菌病病例中有59%（16/27）恢复，细菌性角膜炎病例中有75%（15/20）恢复（P = 0.264）。
尽管曲霉菌和兽疫链球菌是最常见的分离株，但细胞学检查、培养及药敏试验对于鉴别细菌性和真菌性角膜炎并指导临床医生选择最有效的治疗方法至关重要。
