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一家三级眼科中心的儿童非病毒性微生物性角膜炎五年报告

A five-year report of pediatric non-viral microbial keratitis in a tertiary eye center.

作者信息

Tas Muhammed Dara, Palamar Melis, Aydemir Sabire Sohret, Selver Ozlem Barut

机构信息

Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova-Izmir, Turkey.

Department of Microbiology, Ege University, Izmir, Turkey.

出版信息

Int Ophthalmol. 2025 Mar 18;45(1):110. doi: 10.1007/s10792-025-03463-z.

DOI:10.1007/s10792-025-03463-z
PMID:40100463
Abstract

PURPOSE

To evaluate the demographic data, risk factors, clinical outcomes, microbial spectrum, and treatment in pediatric microbial keratitis cases.

METHODS

The medical data including demographics, predisposing factors, accompanying diseases, clinical course, and microbial culture results was retrospectively evaluated. A total of 27 patients younger than 18 years who were diagnosed as microbial keratitis in a tertiary referral center between March 2019 and December 2023 were included in the study.

RESULTS

The male/female ratio was 14/13. The mean age was 13.02 ± 6.21 (range, 2-18) years. The most common risk factor was contact lens use (33.8%) followed by trauma (18.5%). The most common accompanied disease was acne rosacea (7.4%). In 20 cases (with a lesion greater than 2 mm in diameter, involving a layer deeper than half of the cornea, etc.) culture samples were taken. Cultures were positive for microbial growth in 8 (40.0%) patients and Pseudomonas aeruginosa was the most frequently isolated organism (25.0%). While 24 (88.8%) of the keratitis improved with medical treatment alone, additional corneal debridement was applied to 2 (7.4%) eyes, and therapeutic penetrating keratoplasty was performed in one refractory case.

CONCLUSION

Although rarer than adult cases, pediatric keratitis is an important entity in childhood due to difficulties and complications in history taking, examination and medication use. This study emphasizes the role of contact lens usage and trauma as the primary causes and Pseudomonas aeruginosa as the most frequent microorganism in pediatric keratitis. Identification of predisposing factors and microorganisms may be helpful for early recognition and treatment.

摘要

目的

评估儿童微生物性角膜炎病例的人口统计学数据、危险因素、临床结局、微生物谱及治疗情况。

方法

回顾性评估包括人口统计学、易感因素、伴发疾病、临床病程及微生物培养结果在内的医学数据。本研究纳入了2019年3月至2023年12月期间在一家三级转诊中心被诊断为微生物性角膜炎的27例18岁以下患者。

结果

男女比例为14/13。平均年龄为13.02±6.21(范围2 - 18)岁。最常见的危险因素是佩戴隐形眼镜(33.8%),其次是外伤(18.5%)。最常见的伴发疾病是玫瑰痤疮(7.4%)。对20例(病变直径大于2mm,累及角膜深度超过一半等)进行了培养样本采集。8例(40.0%)患者培养出微生物生长,铜绿假单胞菌是最常分离出的病原体(25.0%)。24例(88.8%)角膜炎仅通过药物治疗得到改善,2例(7.4%)眼睛进行了额外的角膜清创术,1例难治性病例进行了治疗性穿透性角膜移植术。

结论

尽管儿童角膜炎比成人病例少见,但由于病史采集、检查及用药方面的困难和并发症,它在儿童时期是一个重要问题。本研究强调了佩戴隐形眼镜和外伤作为儿童角膜炎主要病因的作用,以及铜绿假单胞菌作为最常见微生物的地位。识别易感因素和微生物可能有助于早期识别和治疗。

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Cornea. 2023 Sep 1;42(9):1099-1103. doi: 10.1097/ICO.0000000000003264. Epub 2023 Mar 7.
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Update on pediatric corneal diseases and keratoplasty.小儿角膜疾病与角膜移植术的最新进展
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Contact Lens-Associated Keratitis-an Often Underestimated Risk.接触镜相关角膜炎——一个常被低估的风险。
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Pediatric Non-Viral Microbial Keratitis: Predisposing Factors, Microbiological Profile, Treatment Modalities, and Visual Outcome.儿童非病毒性微生物性角膜炎:易感因素、微生物学特征、治疗方式及视力预后
Clin Ophthalmol. 2022 Mar 15;16:775-783. doi: 10.2147/OPTH.S323408. eCollection 2022.
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Comparison of Culture-Positive and -Negative Microbial Keratitis.阳性和阴性微生物角膜溃疡的比较。
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A ten-year report of microbial keratitis in pediatric population under five years in a tertiary eye center.一家三级眼科中心五岁以下儿童微生物性角膜炎的十年报告。
J Ophthalmic Inflamm Infect. 2020 Nov 27;10(1):35. doi: 10.1186/s12348-020-00227-x.
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A global perspective of pediatric non-viral keratitis: literature review.儿童非病毒性角膜炎的全球视角:文献回顾。
Int Ophthalmol. 2020 Oct;40(10):2771-2788. doi: 10.1007/s10792-020-01451-z. Epub 2020 Jun 4.
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Contact Lens-Associated Microbial Keratitis in a Tertiary Eye Care Center in Turkey.土耳其一家三级眼科保健中心的接触镜相关微生物性角膜炎。
Eye Contact Lens. 2020 Mar;46(2):110-115. doi: 10.1097/ICL.0000000000000617.
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