Fazekas Balázs, Jayakumar Delicia, Dua Harminder Singh, Faraj Lana
ST5 Ophthalmology Trainee, University Hospitals of Derby and Burton NHS, Derby, UK.
Specialty and Associate Specialty Grade, SAS Ophthalmology Doctor, Sherwood Forest Hospitals Foundation Trust, Mansfield, UK.
Int Ophthalmol. 2025 Jan 31;45(1):58. doi: 10.1007/s10792-025-03432-6.
To assess the spectrum of organisms causing microbial keratitis and their in-vitro anti-microbial sensitivities out of 2 hospitals in the East Midlands Region of the United Kingdom.
A retrospective review was undertaken of all patients who underwent corneal scrapes for infectious keratitis between 2011 and 2021 at Royal Derby Hospital (RDH) in Derby and between 2009 and 2021 at King's Mill Hospital in Mansfield.
In total, the results of 645 corneal scrapes (from 622 patients) were analysed after exclusions. Of these, 307 (47.6%) yielded positive cultures. The mean patient age was 52.6 ± 22.1 years (Mean ± St Dev) across both sites and 332 (51.4%) were from female patients. At RDH, there were 195 positive corneal scrape cultures, from which 250 species of organisms were isolated. At RDH, 64% (160/250) were Gram-positive bacteria, 32% (81/250) were Gram-negative bacteria, 2.4% (6/250) were Acanthamoeba species and 1.2% were fungi (3/250). At KMH, there were 112 positive cultures, from which 128 species of organisms were isolated. 14 corneal scrapes from KMH were polymicrobial. At KMH, 96% (123/128) were bacterial (51% Gram positive, 45% Gram negative), 3/128 (2.3%) were fungi and 2/128 (1.6%) were Acanthamoeba. Sensitivity testing confirmed that the fluoroquinolone class of antibiotics appeared to be effective against the majority isolates across the two hospital sites.
There are differences in microbiological profiles between these neighbouring hospitals covering neighbouring populations. Despite these differences, reassuringly, the current first-line fluoroquinolone monotherapy treatment is an appropriate first-line treatment for both hospital sites.
评估英国东米德兰兹地区两家医院中引起微生物性角膜炎的微生物种类及其体外抗菌敏感性。
对2011年至2021年期间在德比的皇家德比医院（RDH）以及2009年至2021年期间在曼斯菲尔德的国王磨坊医院因感染性角膜炎接受角膜刮片检查的所有患者进行回顾性研究。
排除后，共分析了645例角膜刮片（来自622名患者）的结果。其中，307例（47.6%）培养结果呈阳性。两个医院的患者平均年龄为52.6±22.1岁（平均值±标准差），女性患者有332例（51.4%）。在RDH，有195例角膜刮片培养结果呈阳性，从中分离出250种微生物。在RDH，64%（160/250）为革兰氏阳性菌，32%（81/250）为革兰氏阴性菌，2.4%（6/250）为棘阿米巴属，1.2%为真菌（3/250）。在KMH，有112例培养结果呈阳性，从中分离出128种微生物。KMH的14例角膜刮片为混合微生物感染。在KMH，96%（123/128）为细菌（51%为革兰氏阳性菌，45%为革兰氏阴性菌），3/128（2.3%）为真菌，2/128（1.6%）为棘阿米巴。敏感性测试证实，氟喹诺酮类抗生素似乎对两家医院的大多数分离菌株有效。
这些相邻医院覆盖相邻人群，其微生物学特征存在差异。尽管存在这些差异，但令人放心的是，目前的一线氟喹诺酮单药治疗对两家医院来说都是合适的一线治疗方法。
