Blaser Frank, Bajka Anahita, Grimm Felix, Metzler Simone, Herrmann Didier, Barthelmes Daniel, Zweifel Sandrine Anne, Said Sadiq
Department of Ophthalmology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
Institute of Parasitology, University of Zurich, 8057 Zurich, Switzerland.
Microorganisms. 2024 Jun 17;12(6):1214. doi: 10.3390/microorganisms12061214.
Ophthalmologists' diagnostic and treatment competence in Acanthamoeba keratitis varies widely. This investigator-initiated, retrospective, single-center chart review examined the electronic patient files regarding PCR-positive Acanthamoeba keratitis. We included corneal and contact lens assessments. We further reviewed the patient's medical history, corneal scraping results regarding viral or fungal co-infections, and the duration from symptom onset to final diagnosis. We identified 59 eyes of 52 patients from February 2010 to February 2023, with 31 of 52 (59.6%) being female patients. The median (IQR, range) patient age was 33 (25.3 to 45.5 [13 to 90]) years, and the mean (SD, range) time to diagnosis after symptom onset was 18 (10.5 to 35 [3 to 70]) days. Overall, 7 of 52 (7.7%) patients displayed a bilateral Acanthamoeba infection, and 48 (92.3%) used contact lenses at symptom onset. Regarding other microbiological co-infections, we found virologic PCR testing in 45 of 52 (86.5%) patients, with 3 (6.7%) positive corneal scrapings. Fungal cultures were performed in 49 of 52 (94.2%) patients, with 5 (10.2%) positive corneal scrapings. The medical treatment success rate was 45/46 (97.8%). This study raises awareness of patient education in contact lens handling and screens for further microbial co-infections in suspected Acanthamoeba cases.
眼科医生对棘阿米巴角膜炎的诊断和治疗能力差异很大。这项由研究者发起的回顾性单中心病历审查,检查了关于PCR检测呈阳性的棘阿米巴角膜炎患者的电子病历。我们纳入了角膜和隐形眼镜评估。我们还回顾了患者的病史、角膜刮片检测病毒或真菌合并感染的结果,以及从症状出现到最终诊断的时间。我们确定了2010年2月至2023年2月期间52例患者的59只眼,其中52例中有31例(59.6%)为女性患者。患者年龄中位数(IQR,范围)为33岁(25.3至45.5 [13至90]),症状出现后至诊断的平均(SD,范围)时间为18天(10.5至35 [3至70])。总体而言,52例患者中有7例(7.7%)出现双侧棘阿米巴感染,48例(92.3%)在症状出现时使用隐形眼镜。关于其他微生物合并感染,我们发现52例患者中有45例(86.5%)进行了病毒PCR检测,其中3例(6.7%)角膜刮片呈阳性。52例患者中有49例(94.2%)进行了真菌培养,其中5例(10.2%)角膜刮片呈阳性。药物治疗成功率为45/46(97.8%)。本研究提高了对隐形眼镜使用患者教育的认识,并对疑似棘阿米巴病例进一步筛查微生物合并感染。