Ting Darren Shu Jeng, Ho Charlotte Shan, Deshmukh Rashmi, Said Dalia G, Dua Harminder S
Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.
Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK.
Eye (Lond). 2021 Apr;35(4):1084-1101. doi: 10.1038/s41433-020-01339-3. Epub 2021 Jan 7.
Corneal opacity is the 5th leading cause of blindness and visual impairment globally, affecting ~6 million of the world population. In addition, it is responsible for 1.5-2.0 million new cases of monocular blindness per year, highlighting an ongoing uncurbed burden on human health. Among all aetiologies such as infection, trauma, inflammation, degeneration and nutritional deficiency, infectious keratitis (IK) represents the leading cause of corneal blindness in both developed and developing countries, with an estimated incidence ranging from 2.5 to 799 per 100,000 population-year. IK can be caused by a wide range of microorganisms, including bacteria, fungi, virus, parasites and polymicrobial infection. Subject to the geographical and temporal variations, bacteria and fungi have been shown to be the most common causative microorganisms for corneal infection. Although viral and Acanthamoeba keratitis are less common, they represent important causes for corneal blindness in the developed countries. Contact lens wear, trauma, ocular surface diseases, lid diseases, and post-ocular surgery have been shown to be the major risk factors for IK. Broad-spectrum topical antimicrobial treatment is the current mainstay of treatment for IK, though its effectiveness is being challenged by the emergence of antimicrobial resistance, including multidrug resistance, in some parts of the world. In this review, we aim to provide an updated review on IK, encompassing the epidemiology, causative microorganisms, major risk factors and the impact of antimicrobial resistance.
角膜混浊是全球第五大致盲和视力损害原因，影响着约600万世界人口。此外，它每年还导致150万至200万例单眼失明新病例，凸显了对人类健康持续未得到控制的负担。在感染、创伤、炎症、变性和营养缺乏等所有病因中，感染性角膜炎（IK）在发达国家和发展中国家都是角膜盲的主要原因，估计发病率为每10万人年2.5至799例。IK可由多种微生物引起，包括细菌、真菌、病毒、寄生虫和混合感染。受地理和时间变化的影响，细菌和真菌已被证明是角膜感染最常见的致病微生物。尽管病毒性和棘阿米巴角膜炎不太常见，但它们是发达国家角膜盲的重要原因。隐形眼镜佩戴、创伤、眼表疾病、眼睑疾病和眼科手术后已被证明是IK的主要危险因素。广谱局部抗菌治疗是目前IK治疗的主要手段，尽管其有效性在世界某些地区正受到抗菌药物耐药性（包括多重耐药性）出现的挑战。在本综述中，我们旨在提供关于IK的最新综述，包括流行病学、致病微生物、主要危险因素以及抗菌药物耐药性的影响。
