华南地区某眼科医院的感染性角膜炎病原菌谱特征

目的:探讨华南地区某眼科医院感染性角膜炎的病原菌谱及其特点。方法:回顾性系列病例研究。选择2013年7月1日至2017年12月31日在中山大学中山眼科中心进行角膜取材和微生物检测的角膜感染患者3914例。表面麻醉后刮取病灶边缘的病灶组织,进行细菌、真菌培养及鉴定。培养结果阳性的细菌采用生化比色或质谱进行种属鉴定;真菌依据形态学进行种属鉴定。各季节菌谱阳性率差异比较采用卡方检验。结果:感染性角膜炎患者中,男2468例(63.1%),女1446例(36.9%),年龄(49.5±16.8)岁。病原菌培养阳性的患者共1673例(42.7%),其中单纯细菌749例(44.8%),单纯真菌849例(50.7%),混合感染75例(4.5%)。最常见的细菌是葡萄球菌属(20.1%),其次是假单胞菌属(7.5%);最常见的真菌是镰刀菌属(25.5%),其次是曲霉菌属(10.3%)。细菌的阳性率在5-8月明显高于1-2月和9-12月(P<0.05),真菌的阳性率在5-6月明显低于1-2月和9-12月(P<0.05)。结论:在华南地区一所三甲眼科医院的感染性角膜炎中,真菌感染略高于细菌感染,且细菌和真菌感染存在季节性差异。

Microbial Spectrum of Infectious Keratitis in an Ophthalmic Hospital in Southern China

Objective: To investigate the pathogenic microbial spectrum and seasonal distribution characteristics of infectious keratitis in southern China. Methods: In this retrospective case series study, all results of corneal microbiological examinations of patients with infectious keratitis, from July 1, 2013 to December 31, 2017, at Zhongshan Ophthalmic Center, Sun Yat-sen University, were reviewed and analyzed. The scraped corneal specimens of patients with keratitis were subjected to an examination of bacteria and fungi in the hospital's clinical laboratory. A chi square test was used for statistical analysis. Results: Of 3 914 samples, 2 468(63.1%) were from males and 1 446(36.9%) were from females, with an average age of 49.5±16.8 years. The microbial testing was positive in 1 673 cases (42.7%). Among them, 749(44.8%) were positive for bacteria, 849 (50.7%) were positive for fungi, and 75(4.5%) were co-infections with both fungi and bacteria. The most common type of bacteria isolated was Staphylococcus epidermidis (20.1%), followed by Pseudomonas aeruginosa (7.5%). The most common type of fungi was the Fusarium species (25.5%), followed by the Aspergillus species (10.3%). The prevalence of bacteria was significantly higher in May to August than in September to February of the following year (P<0.05), and the prevalence of fungi was significantly lower in May to June than in September to February of the following year (P<0.05). Conclusions: Fungi infection is slightly higher than bacterial infection in infectious keratitis in southern China. There are seasonal variations in bacterial and fungal infections.