眼部真菌感染的病原学及体外药物敏感性分析

目的 分析4年间眼部感染的真菌菌属分布及其体外药物敏感性。方法 收集2179份眼部标本进行分离培养，对真菌培养阳性率、菌属的种属分布、菌属的季节分布及年龄与性别分布进行回顾性分析；同时分析培养阳性的真菌对常用抗真菌药物的敏感性。结果 共培养阳性菌株681株，阳性率为31．25％，其中镰刀菌属394株（57．86％），曲霉菌属116株（17．03％）。培养阳性的标本中，角膜591株（86．78％）、房水29株（4．26％）、结膜22株（3．23％）、玻璃体22株（3．23％）、泪囊1株（0．15％）、其他16株（2．35％）。体外药物敏感性观察发现，镰刀菌中368株对那他敏感（93．40％），曲霉菌中107株对伊曲康唑敏感（92．24％）。结论 镰刀菌属及曲霉菌属仍是我国北方主要的眼部致病真菌菌属；镰刀菌对那他霉素最敏感，曲霉菌对伊曲康唑最敏感。     

103例角膜溃疡的病因和病原及药物敏感试验的统计分析

对１９９５年１—１２月间我院门诊１０３例角膜溃疡的病因、病原和药物敏感试验进行统计分析。病因：外伤５９例（５７．２８％），继发感染３４例（３３．０１％），原因不明８例（７．７７％），戴接触镜２例（１．９４％）。病原：真菌３５例（３３．９８％），绿脓杆菌１８例（１７．４８％），金黄色葡萄球菌１５例（１４．５６％），表皮葡萄球菌９例（８．７４％），淋球菌２例（１．９４％）。对１９例真菌性角膜溃疡同时进行细菌培养，有７例为混合感染，占３６．８４％。对几种主要检出菌的药物敏感试验表明：它们对普通抗菌素均可产生一定的耐药性     

真菌性角膜溃疡的临床及真菌学研究

目的探讨真菌性角膜溃疡致病菌种类的变迁及其对临床常用抗真菌药物的敏感性。方法对拟诊为真菌性角膜溃疡的57例（57只眼）患者培养出的46株致病性真菌进行调查分析,并将所分离的菌株分别做常用抗真菌药物的敏感试验。结果 57例标本中,涂片镜检可见菌丝或孢子者有49例,阳性率为85.96%,养出致病性真菌46株,阳性率为80.70%,主要致病性真菌依次为镰刀菌属（56.52%）,曲霉属（39.13%）和毛霉菌属（4.35%）。46株真菌对伊曲康唑和两性霉素B有较高敏感性。结论真菌性角膜溃疡主要致病性真菌为镰刀菌属和曲霉菌属,伊曲康唑和两性霉素B对大多数真菌有较高敏感性。     

中国热带地区真菌性角膜溃疡致病菌种类及药物敏感性分析

背景 海南省处于中国热带和亚热带地区,全年的气候特点适宜真菌生长繁殖,该地区真菌感染性眼病发病率较高,分析致病菌并了解其敏感药物对感染性眼病的临床治疗有重要意义. 目的 探讨中国海南省及其南海诸岛屿热带地区真菌性角膜溃疡致病菌种类及其对临床常用抗真菌药物的敏感性.方法 采用系列病例观察研究方法,收集2014年2月至2016年5月在中山大学中山眼科中心海南眼科医院诊断为真菌性角膜溃疡者174例174眼,所有患者均来自海南省及其南海诸岛屿热带地区,诊断方法参照《眼科学》(第五版)中的标准.无菌条件下刮取角膜溃疡的进展缘或基底部的菌丝苔被,采用KOH湿片法直接涂片行真菌检查;将采集的标本接种于马铃薯葡萄糖琼脂培养基和沙氏培养基进行真菌培养,对培养出的82株致病性真菌参照《全国临床检验操作规程》(第3版)和《实用临床微生物学检验与图谱》进行菌种鉴定,采用纸片扩散法对分离的菌株行10种抗真菌药物的药物敏感性试验. 结果 涂片镜检的126例中可见菌丝和孢子者34例,阳性率为27.0％;真菌培养的174例标本中培养出致病性真菌82株,阳性率为47.1％,主要致病性真菌依次为镰刀菌属、不产孢子菌、曲霉属和茎点霉属,分别占47.5％、12.2％、9.8％和9.8％.行药物敏感性试验的77株真菌对制霉菌素、两性霉素B和特比萘芬敏感性较好,敏感率分别为88.3％、72.7％和71.4％.结论 中国海南省及南海诸岛屿热带地区真菌性角膜溃疡的主要致病菌为镰刀菌属、不产孢子菌、曲霉属和茎点霉属,这些致病真菌对制霉菌素、两性霉素B和特比萘芬的敏感性较高.     

眼部真菌感染的病原学分析

目的：分析眼部感染的真菌菌属分布与变化。方法：对首都医科大学北京同仁眼科中心1989－2000年送检的2609份眼部真菌标本进行培养,并对真菌培养的阳性率、季节分布、菌属分布及其变化进行回顾性分析。结果：2609份眼部真菌培养标本中,真菌培养阳性775株（29．70％）。其中角膜标本707株（91．22％）,结膜标本22株（2．84％）,前房标本15株（1．94％）,玻璃体标本9株（1．16％）,泪囊标本3株（0．39％）,其他19株（2．45％）。培养阳性菌株季节特点：1－6月份共培养出249株（32．13％）,7－12月份培养出526株（67．87％）,两者比约1∶2．1。主要培养阳性菌属为镰刀菌属,共455株（58．71％）。其中1989－1994年共培养出阳性镰刀菌96株,占总检出菌数的53．63％;1995－2000年共培养出359株,占总检出菌数的60．23％,后6年校前6年增加了6．60％。其次为曲霉菌属,共130株（16．77％）,前6年培养出40株（22．35％）,后6年90株,占总检出菌数的15．10％,后6年校前6年下降7．25％。结论：镰刀菌属是我国北方地区主要的眼部致病菌属,曲霉菌属致病的比例有所下降。     

127例外源性化脓性眼内炎病原体及药敏试验结果分析

目的：分析外源性化脓性眼内炎病原体及其对药物敏感性的变迁，为临床合理用药提供依据。方法：对127例(127眼)经临床诊断为化脓性眼内炎的前房水或玻璃体液标本进行涂片检查、细菌培养、真菌培养，对细菌培养阳性菌株进行药物敏感试验，然后对培养结果及药物敏感试验结果进行统计分析。结果：外源性化脓性眼内炎涂片阳性率为22．05％，细菌及真菌培养阳性率为42．52％。其主要致病菌为表皮葡萄球菌、枯草杆菌及铜绿假单孢杆菌。大多数细菌对环丙沙星敏感，对氯霉素、利福平、头孢唑琳耐药。结论：对化脓性眼内炎患者的前房水或玻璃体液进行涂片、培养及药物敏感试验有助于明确眼内炎的性质及指导临床用药的选择。     

临床细菌性眼内炎的病原学分析

目的探讨细菌性眼内炎致病菌的菌属分布及其药物敏感性,为临床诊断与治疗提供依据。方法对1999年1月至2006年12月北京同仁眼科中心临床送检的728份房水和玻璃体标本,进行常规细菌培养鉴定和纸片扩散法药物敏感性试验;对培养阳性菌株的菌属分布及其药物敏感性进行回顾性分析。结果728份房水和玻璃体标本中,细菌培养阳性标本160份,平均培养阳性率为22．0％;共培养出168株细菌,其中革兰阳性球菌96株（57．1％）,革兰阳性杆菌18株（10．7％）,革兰阴性球菌2株（1．2％）,革兰阴性杆菌52株（31．0％）。主要分离菌为表皮葡萄球菌36株（21．4％）,金黄色葡萄球菌19株（11．3％）,铜绿假单胞菌15株（8、9％）。革兰阳性球菌对万古霉素敏感率为93．4％（85／91）、对左旋氧氟沙星为84．4％（81／96）,革兰阴性杆菌对左旋氧氟沙星敏感率为88．2％（45／51）、对氧氟沙星为76．9％（40／52）、对环丙沙星为75．0％（39／52）。前4年（1999年至2002年）与后4年（2003年至2006年）主要致病菌药物敏感性比较,结果发现常用药物的敏感性均有不同程度的下降。结论细菌性眼内炎致病菌谱较广,临床常用抗菌药单一使用时常不能有效覆盖主要致病菌,因此治疗时应考虑联合用药。     

天津地区角膜外伤后真菌感染的病原学调查分析

目的调查分析天津地区角膜真菌感染的病原菌种类。方法自2006年1月至2009年6月间，在天津市眼科医院采集角膜外伤后疑似真菌性角膜炎病变角膜标本170份，分别进行真菌直接涂片镜检和接种于沙保罗培养基进行真菌培养，对培养阳性者进行菌种鉴定。结果在170份角膜病变标本中，直接涂片镜检阳性98份，阳性率为57．65％。真菌培养阳性123株，阳性率为72．35％；涂片镜检和真菌分离培养的一致性为84．75％。其中镰刀菌属占66．67％，镰刀菌属中茄病镰刀菌占30．89％，尖孢镰刀菌占15．45％，串珠镰刀菌占13．82％。曲霉菌属占23．58％，曲霉菌属中黄曲霉菌占13．01％，烟曲霉菌占8．14％。结论镰刀菌属和曲霉菌属是天津地区眼部真菌感染的主要致病真菌。     

角膜丝状真菌感染病原学检查及药物敏感分析

目的 分析天津地区角膜丝状真菌感染的菌属分布及其体外药物敏感试验.方法 自2006年1月至2009年6月间,在天津市眼科医院采集疑似真菌性角膜炎患者病变角膜标本170份,分别进行真菌茁陵涂片镜检和接种于沙保罗培养基进行真菌培养,培养阳性者应用真菌微量药敏板分析对常用抗真菌药物的敏感性.结果 在170份角膜病变标本中,直接涂片镜检阳性98份,阳性率为57.6%.丝状真菌培养阳性118株,阳性率为69.4%;涂片镜检和真菌分离培养的一致性为84.7%.其中镰刀菌属占69.5%,曲霉菌属占24.6%.镰刀菌属对伏立康唑最为敏感(97.6%),其次为两性霉素B(84.2%).对伊曲康唑和氟康唑不敏感.曲霉菌属对伏立康唑最敏感(96.6%),其次为特比萘芬(93.1%)和两性霉素B(86.2%),对伊曲康唑和氟康唑不敏感.结论 镰刀菌属和曲霉菌属是眼部真菌感染的主要致病真菌.绝大多数菌株对伏立康唑、两性霉素B和特比萘芬敏感,对伊曲康唑和氟康唑耐药性较高.     

中国华南地区真菌性角膜炎致病菌谱变化

背景 真菌性角膜炎发病率高,临床治疗比较困难,其病原学诊断和鉴定是改善疾病预后的前提.近年来随着地区环境和气候的不断变化,真菌性致病菌的菌属分布是否发生改变值得关注. 目的 分析近年来华南地区真菌性角膜炎致病菌的分布状况. 方法 对2009年1月至2014年12月在中山大学中山眼科中心收集和培养的化脓性角膜溃疡刮取标本3 350份进行回顾性分析,对真菌培养阳性率及致病真菌株的种属分布进行鉴定,并评估不同年段和不同季节的变化.结果 培养的3 350份标本中真菌培养阳性者1 050株(1 050例),每年平均175株,阳性率为31.34％,其中镰刀菌属337株,占32.10％;曲霉菌属270株,占25.71％;禾草蠕孢霉菌属150株,占14.29％;毛霉菌属96株,占9.14％;弯孢霉属与青霉菌属各65株,各占6.19％.2009-2010年培养的阳性菌株367株,占36.05％;2011-2012年阳性菌株329株,占32.45％;2013-2014年阳性菌株354株,占26.86％.各年段真菌检出阳性率的差异有统计学意义(x2=22.37,P＜0.01).1～3月培养的阳性菌株261株,占31.15％;4～6月阳性菌株182株,占25.53％;7～9月阳性菌株237株,占30.00％;10 ～ 12月阳性菌株370株,占36.67％;各季度间阳性菌株检出率的差异有统计学意义(x2=25.19,P＜0.01),各种致病真菌的检出率以10～ 12月最高,4～6月最低.结论 中国华南地区真菌性角膜溃疡的致病菌以镰刀菌属居首位,其次依次为曲霉菌属、禾草蠕孢霉菌属、毛霉菌属、膝曲弯孢霉菌属和青霉菌属.真菌感染率最高的季节是10 ～12月.2009-2014年真菌性角膜溃疡仍处于高发期,但在华南地区发病率呈下降趋势.     

Distribution and shifting trends of bacterial keratitis in north China (1989-98)

AIMS: To study the distribution and shifting trends of bacterial keratitis. METHODS: The data of 2220 corneal isolates from 1 January 1989 to 31 December 1998 were reviewed retrospectively. RESULTS: Positive culture was recovered in 490 isolates. Gram positive cocci and Gram negative bacilli represented 51% and 39.4%, respectively. Pseudomonas aeruginosa was the most common pathogen (32.2%). A gradual increase in the percentage of Gram positive cocci coupled with a decrease of Gram negative bacilli. CONCLUSION: Pseudomonas aeruginosa and coaculase negative Staphylococcus were the most common pathogens in bacterial keratitis in north China.     

Bacterial keratitis in patients with and without contact lens anamnesis]

BACKGROUND: The study shows differences between contact lens wearers and patients without history of contact lenses regarding the spectrum of etiological agents in bacterial keratitis. Based on microbiological analysis, there are given recommendations for an optimal initial antibiotic treatment in both groups. MATERIAL AND METHODS: From 1989 to 1997 smears, scrapings and corneal biopsies were taken from 218 patients with bacterial keratitis. The causing pathogens were isolated on directly inoculated culture media and identified by staining and microscopy. The resistance pattern of a total of 275 germs was analysed for different antibiotics. RESULTS: The most frequently isolated germs were Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus spp., Propionibacterium acnes and Pseudomonas aeruginosa. Whereas sensitive gram-positive germs were predominating in contact lens wearers as well as in non-contact lens wearers, multiresistant gram-negative germs could nearly exclusively be isolated from contact lens wearers. Frequently administered antibiotics like aminoglycosides and quinolones are effective in infections caused by Staphylococcus spp., but increasing resistance could be seen to Streptococcus spp. In this case, erythromycin is very sensitive. Gram-negative germs like Pseudomonas aeruginosa are sensitive to quinolones and some aminoglycosides (e.g. tobramycin). CONCLUSION: In contact lens wearers, more aggressive germs have to be considered than in non-contact lens wearers. In such cases, frequently administered antibiotics like amino-glycosides are not effective. To cover problematic gram-negative germs we recommend the application of quinolones alternating with erythromycin. The latter one is more effective than quinolones and aminoglycosides in case of Streptococcus spp. co-involvement.     

Epidemiological, clinical and laboratory findings of infectious keratitis at Mansoura Ophthalmic Center, Egypt

AIM: To analyze the epidemiological, clinical and laboratory findings of infectious keratitis. METHODS: A retrospective study on cases of infective keratitis, attended our institution from Mar. 2013 to Feb. 2015, was done at Mansoura Ophthalmic Center, Egypt. Corneal scrapings were performed and processed for direct microscopy and culture in appropriate media using standard laboratory protocols. RESULTS: Out of 245 patients enrolled for study, 247 corneal scrapings were obtained. Ocular trauma was the most common predisposing factor (51.4%), followed by diabetes mellitus (15.1%). Cultures were positive in 110 scraping samples (44.5%): 45.5% samples had pure fungal infection, 40% had pure bacterial infections and 10% had mixed fungal and bacterial growths. Acanthamoeba was detected in 5 (4.5%) samples. The most common fungal pathogen was Aspergillus spp. (41%). The most common bacterial isolates were Staphylococcus aureus (38.2%) and Pseudomonas aeruginosa (21.8%). CONCLUSION: Incidence of fungal keratitis is high in our region. Therapeutic approach can initially be based on clinical features and sensitivity/resistance patterns. Microbiological research should direct the antimicrobial treatment. Antibiotic resistance to fluoroquinolones and aminoglycosides is an important consideration.     

Fourth-generation fluoroquinolone-resistant bacterial keratitis after refractive surgery

We report the first 2 cases of bacterial keratitis resistant to fourth-generation fluoroquinolones after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). The first patient had Pseudomonas aeruginosa keratitis after PRK despite treatment with moxifloxacin. The second patient was on gatifloxacin post-LASIK when she had methicillin-resistant Staphylococcus aureus (MRSA) keratitis diagnosed. In both cases, culture susceptibilities showed isolates resistant to moxifloxacin and gatifloxacin, and treatment with topical aminoglycosides and surgical intervention was necessary to effect a cure. These cases show the potential limitations in the coverage of these antibiotics.     

Infectious keratitis in South Australia: emerging resistance to cephazolin

PURPOSE: To analyze the microbiologic spectrum and patterns of resistance of infectious keratitis in patients treated at a tertiary hospital in South Australia. METHODS: Retrospective review of microbiology laboratory records of all patients with infectious keratitis who had corneal scrapings, from 1998 to 2003. All records were subsequently reviewed for Gram staining and culture results, as well as antibiotic sensitivity and resistance. RESULTS: Positive corneal cultures were obtained in 134 out of 211 patients who had corneal scrapings (63.5%). Coagulase negative Staphylococcus was the commonest pathogen identified (29.8% of positive cultures), followed by Staphylococcus aureus (18.7%), Pseudomonas aeruginosa (12.7%), Moraxella (6.7%), Streptococcus pneumonia (6.0%), and fungal keratitis (5.2%). In 43.3% of culture positive cases, the organisms were also identified in Gram stain, and in all these cases there was a full correlation between the two methods. In vitro sensitivities were highest for gentamicin. Fourteen cases (35%) of coagulase negative Staphylococcus were found to be resistant to cephazolin. No ciprofloxacin resistance was identified in all Pseudomonas isolates tested. CONCLUSIONS: Staphylococcus species continue to be the commonest causative organism for infectious keratitis; however, there is an emerging resistance to cephazolin, which is commonly used as the first-line antibiotic for Gram-positive cocci.     

Shifting trends in bacterial keratitis in south Florida and emerging resistance to fluoroquinolones

OBJECTIVE: To study the distribution, current trends, and patterns of resistance to antimicrobial agents of bacterial keratitis isolates in South Florida. DESIGN: Retrospective, observational, case series. PARTICIPANTS: The microbiology records of all patients with bacterial keratitis seeking treatment at the Bascom Palmer Eye Institute from January 1, 1990 through December 31, 1998 were reviewed. MAIN OUTCOME MEASURES: In vitro laboratory minimum inhibitory concentration testing of the corneal isolates to the fluoroquinolones (ofloxacin and ciprofloxacin) and to the aminoglycosides (tobramycin and gentamicin) was performed using the Vitek (Automatic Microbial System Biomerieux Vitek, Inc., Hazelwood, Missouri) method. RESULTS: During this 9-year period, 2920 consecutive corneal cultures were obtained, and a pathogen was recovered in 1468 cultures (50%). The number of corneal ulcers scraped, positive cultures, recovered bacterial isolates, and ratio of gram-positive to gram-negative isolates per year remained approximately equal throughout the study period. Staphylococcus aureus and Pseudomonas aeruginosa represented 19.4% and 25.7%, respectively, of the total bacterial isolates during this period. However, we documented a gradual increase in the number of S. aureus keratitis isolates (29% of gram-positive organisms in 1990 versus 48% in 1998, P = 0.01) coupled with a decrease in the number of P. aeruginosa isolates (54% of gram-negative organisms in 1990 versus 46% in 1998). A decrease in the incidence of contact lens-associated keratitis and P. aeruginosa isolates in this group of patients was documented. Serratia marcescens and P. aeruginosa were most commonly isolated in contact lens-associated keratitis (18% each). There was increasing laboratory resistance of S. aureus keratitis isolates to the fluoroquinolones (11% in 1990 to 28% in 1998), but resistance patterns to the aminoglycosides remained unchanged. There was a three-fold increase in the percentage of resistant S. aureus isolates to fluoroquinolones between 1990 and 1994 and between 1995 and 1998. Both fluoroquinolones and aminoglycosides exhibited low in vitro effectiveness against P. aeruginosa throughout the study period. CONCLUSIONS: The increased recovery of S. aureus keratitis isolates and decreased laboratory effectiveness against fluoroquinolones to these pathogens present an important therapeutic challenge.     

细菌性角膜炎病原学分析

目的：回顾分析细菌性角膜炎致病菌属的分布及变化。方法：对1989－1999年间送检的2220份细菌性角膜炎细菌培养标本进行革兰染色及分类,对不同菌属的分布及变化情况进行回顾性分析。结果：在2220份培养的角膜细菌标本中,培养阳性菌株490 株,阳性率为22．1％。其中革兰阳性球菌250株,占51．0％;革兰阴性球菌2株,占0．4％;革兰阴性杆菌193株,占39．4％;革兰阳性杆菌45株,占9．2％。假单胞菌属的检出率最高,占32．2％,其次为凝固酶阴性葡萄球菌属为18．6％,第3位肺炎球菌12．0％。10年中,革兰阳性球菌检出率呈上升趋势,革兰阴性杆菌检出率则呈下降趋势。结论：假单胞菌属及凝固酶阴性葡萄球菌属仍是细菌角膜炎较常见的致病菌,革兰阴性杆菌检出率下降与革兰阳性球菌检出率升高趋势应引起临床眼科医师的注意。     

化脓性角膜炎病原学分析

目的分析化脓性角膜炎病原学的变迁特征。方法回顾性分析1989年至2006年间在北京同仁医院眼科拟诊为真菌性、细菌性及棘阿米巴性角膜炎患者11302例微生物实验室检查资料。结果培养鉴定出病原微生物2896份,其中真菌1602份、细菌1161份、棘阿米巴原虫133份,总阳性率为25.62%.真菌培养阳性率为33.83%,夏秋季为高发季节,常见的致病真菌为镰刀菌属(62.23%)和曲霉菌素(14.61%);对2000年至2006年间培养的895株真菌进行体外药敏实验,结果显示那他霉素、特比萘酚、伊曲康唑和氟康唑的药物敏感性分别为88.83%、55·75%、28·60%和11·84%;镰刀菌属对那他霉素最敏感,曲霉菌素对特比萘酚敏感性高。常见细菌培养阳性率为18.78%(1126/5995),以G 球菌和G-杆菌为主,占检出细菌的85·52%;主要致病菌属为铜绿假单胞菌,其所占比例近年来有所下降,而金黄色葡萄球菌、凝固酶阴性葡萄球菌和微球菌属所占比例有明显增高;对2000年至2006年间培养的430株细菌行体外药敏实验,结果显示左氧氟沙星、氧氟沙星、妥布霉素和环丙沙星药物敏感性分别为82.09%、75.81%、66.98%和62.33%;假单胞菌属对4种抗菌药物敏感性无显著性差异。棘阿米巴检查(培养 刮片)阳性率为23.25%(133/572),其检出例数逐年升高。放线菌、非结核分枝杆菌和厌氧菌为少见病原体,非结核分枝杆菌多分离自屈光手术后的角膜感染。结论真菌和细菌为化脓性角膜炎的主要病原体,棘阿米巴角膜炎病例数逐年升高,放线菌及非结核分枝杆菌引起的角膜感染应引起重视。     

Predisposing factors and etiologic diagnosis of ulcerative keratitis

PURPOSE: To determine the predisposing factors, demographic characteristics, and etiology of ulcerative keratitis in a referral center in Bangkok, Thailand. METHODS: The medical records of admitted patients with positive-culture ulcerative keratitis were retrospectively reviewed for demographic data, predisposing factors, and microbial culture results. Predisposing factors were compared between bacterial and fungal keratitis. RESULTS: From January 2001 to December 2004, there were 127 positive-culture ulcerative keratitis cases. The most frequent microbiological diagnosis was bacterial keratitis (76 eyes, 60%), followed by fungal (48 eyes, 38%) and Acanthamoeba keratitis (3 eyes, 2%). The most common organisms isolated were Pseudomonas spp. for bacteria and Fusarium spp. for fungus. Compared with bacterial keratitis, fungal keratitis was more likely to be associated with ocular trauma (odds ratio = 11.20; 95% confidence interval, 3.62-34.66) but less likely to be associated with contact lens wear (odds ratio = 0.02; 95% confidence interval, 0.01-0.08). CONCLUSIONS: In our study, Pseudomonas and Fusarium species are the most common causes of bacterial and fungal keratitis, respectively. Fungal keratitis was more likely than bacterial keratitis to be associated with ocular trauma, whereas fungal keratitis was less likely to be associated with contact lens wear.     

412例真菌性角膜炎的回顾性分析

目的：对真菌性角膜炎患者的流行病学特征、实验室检查方法和结果及治疗效果进行分析,为真菌 性角膜炎诊治提供依据。方法： 回顾性系列病例研究。对2012年1月至2017年12月在冀中能源邢 台矿业集团总医院诊治的412例（412眼）真菌性角膜炎的流行病学特点、临床体征、病原学诊断方式、 结果及治疗效果采用Kruskal-Wallis H检验等统计学方法进行分析。结果：9-12月份是真菌性角膜 炎高发期,占全年患者总数的61.2%（252/412）。患病人群以农民为主,占59.5%（245/412）,植物性 外伤为首要病因者185例（44.9%）,其次为非植物性外伤86例（20.9%）。男女比例为1.82∶1。年龄 14～81（45.6±14.3）岁,41～60岁患者占53.9%（222/412）。真菌培养阳性率为88.8%（366/412）,高 于氢氧化钾湿片法[77.2%（318/412）],2种检测方式比较差异有统计学意义（χ2 =31.14,P<0.001）。 前几位的致病菌依次是镰刀菌属167例（40.5%）,链格孢菌属75例（18.2%）,曲霉菌属62例（15.0%）, 青霉菌属28例（6.9%）。真菌性角膜炎所致典型临床体征中以菌丝苔被最为常见（366例,88.8%）, 其次为伪足（224例,54.4%）、前房积脓（111例,26.9%）。镰刀菌属、链格孢菌属、曲霉菌属及青 霉菌属所致真菌性角膜炎的病情分级和预后水平比较差异均有统计学意义（Hc=40.676,P< 0.001; Hc=40.109,P<0.001）,显示镰刀菌属和曲霉菌属的病情分级重于链格孢菌属和青霉菌属,预后水平 也差于链格孢菌属和青霉菌属。结论：真菌性角膜炎患者呈逐年增多趋势;氢氧化钾湿片法和真菌 培养都是有效的诊断方法,镰刀菌属和曲霉菌属所致的真菌性角膜炎较链格孢菌和青霉菌引起的真 菌性角膜炎病情相对较重,且预后较差。