Milanez Edlâny Pinho Romão, de Souza Pedro de Freitas Santos Manzi, Monteiro Ruan Campos, Pereira Lívia Maria Galdino, Peixoto Paulo Henrique Soares, de Oliveira Denis Francisco Gonçalves, Colares Pedro Paulo Rodrigues, Teixeira Raielly Furtado, Andrade Marília de Freitas Chaves E, Silva Jailton Vieira, Rodrigues Anderson Messias, de Souza Collares Maia Débora Castelo Branco, Cordeiro Rossana de Aguiar
Federal University of Ceará Fortaleza, Fortaleza, Ceará, Brazil.
Emílio Ribas Diagnostic Medicine, Fortaleza, Ceará, Brazil.
Mycoses. 2024 May;67(5):e13728. doi: 10.1111/myc.13728.
Fungal keratitis is a severe eye infection that can result in blindness and visual impairment, particularly in developing countries. Fusarium spp. are the primary causative agents of this condition. Diagnosis of Fusarium keratitis (FK) is challenging, and delayed treatment can lead to serious complications. However, there is limited epidemiological data on FK, especially in tropical areas.
This study aimed to describe the clinical, laboratorial and epidemiological characteristics of FK in a tropical semi-arid region of Brazil.
PATIENTS/METHODS: Adult patients with laboratory-confirmed FK diagnosed between October 2019 and March 2022 were evaluated. Fusarium isolates were characterized at molecular level and evaluated regarding antifungal susceptibility.
A total of 226 clinical samples from patients suspected of keratitis were evaluated; fungal growth was detected in 50 samples (22.12%); out of which 42 were suggestive of Fusarium spp. (84%). Molecular analysis of a randomly selected set of 27 isolates identified F. solani species complex (n = 14); F. fujikuroi sensu lato (n = 6) and F. dimerum sensu lato (n = 7); a total of 10 haplotypes were identified among the strains. All but one Fusarium strains were inhibited by amphotericin B, natamycin and fluconazole. Most patients were male (71.42%; 30 out of 42), aged from 27 to 73 years old. Trauma was the most important risk factor for FK (40.47%; 17 out of 42). Patients were treated with antifungals, corticoids and antibiotics; keratoplasty and eye enucleation were also performed.
The study provided insights into the characteristics of FK in tropical regions and emphasized the importance of enhanced surveillance and management strategies.
真菌性角膜炎是一种严重的眼部感染，可导致失明和视力损害，在发展中国家尤为如此。镰刀菌属是这种疾病的主要病原体。镰刀菌性角膜炎（FK）的诊断具有挑战性，延迟治疗可导致严重并发症。然而，关于FK的流行病学数据有限，尤其是在热带地区。
本研究旨在描述巴西热带半干旱地区FK的临床、实验室和流行病学特征。
患者/方法：对2019年10月至2022年3月期间实验室确诊的成年FK患者进行评估。对镰刀菌分离株进行分子水平鉴定，并评估其抗真菌药敏性。
共评估了226份疑似角膜炎患者的临床样本；50份样本（22.12%）检测到真菌生长；其中42份提示为镰刀菌属（84%）。对随机选择的27株分离株进行分子分析，鉴定出茄病镰刀菌复合种（n = 14）；藤仓镰刀菌复合群（n = 6）和双隔镰刀菌复合群（n = 7）；菌株中共鉴定出10种单倍型。除1株镰刀菌外，所有菌株均被两性霉素B、那他霉素和氟康唑抑制。大多数患者为男性（71.42%；42例中的30例），年龄在27至73岁之间。外伤是FK最重要的危险因素（40.47%；42例中的17例）。患者接受了抗真菌药、皮质类固醇和抗生素治疗；还进行了角膜移植术和眼球摘除术。
该研究提供了对热带地区FK特征的见解，并强调了加强监测和管理策略的重要性。
