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。

Etiological analysis on the ocular fungal infection

OBJECTIVE: To review the distribution and shifting trends of fungal culture specimens in Beijing Institute of Ophthalmology. METHODS: Retrospective analyses of the fungal culture positive rate, the distribution and change of isolates were performed on 2 609 specimens during a 12-year period (1989 - 2000). RESULTS: The number of positive cultures was 775 (707 from the cornea, 91.23%; 22 from the conjunctiva, 2.84%; 15 from anterior chamber, 1.94%; 9 from the vitreous body, 1.16%; 3 from lacrimal sac, 0.39% and 19 from other parts of eye, 2.45%). The average culture-positive rate was 29.70%. The average ratio of the positive cultures between the first half (from January to June) and the second half (from July to December) of the years was 1:2.1. The main genus cultured was Fusarium (58.71%), next was Aspergillus (16.8%). The percentage of Fusarium was increased (53.63% from 1989 through 1994 to 60.23% from 1995 through 2000), and the percentage Aspergillus was decreased (22.35% from 1989 through 1994 to 15.10% from 1995 through 2000). CONCLUSIONS: The Fusaruim is the predominant pathogens of ocular fungal infection in the northern part of China, its frequency was increased during this 12-year period, and meanwhile the frequency of the Aspergillus was decreased. It is very important to comprehend the distribution and shifting trends of pathogenic fungi continuously for diagnosis, prevention and treatment of fungal infectious ocular disease.