海口市眼部真菌感染流行病学与病原学特征分析  

Epidemiological and etiologic characteristies of ocular fungal infection in Haikou

作　　者：宋绪华[1] 邢健强[1] 陈海[1] 毛海燕[1] 陈梨萍[1] 

机构地区：[1]海南医学院附属医院眼科,海南海口570102

出　　处：《南方医科大学学报》2010年第8期1880-1882,共3页Journal of Southern Medical University

基　　金：海南省自然科学基金(807094)

摘　　要：目的探讨海口市眼部真菌感染的流行病学与病原学特征。方法采集眼科门诊及住院患者角膜、结膜、前房、泪囊等部位标本进行真菌培养，对真菌培养的阳性率、季节分布、菌属分布等进行统计学分析。结果共检查683例眼疾患者，真菌培养阳性率为27．96％，其中男、女阳性率分别为33．42％和21．52％，差异有显著性（P〈0．01）。角膜、结膜、前房、泪囊、其他标本（眶周、玻璃体等）的阳性率依次为31．42％、11．32％、10．8l％、21．28％、29．17％，差异有显著性（P〈0．01）。不同职业人群眼部真菌培养阳性率依次为：农民34．88％、工人22．58％、教师11．76％、机关干部4．11％、学生21．43％、其他职业13．33％，差异有显著性（P〈0．01）。不同年龄人群阳性率以21-40岁、41-60岁两个年龄组较高，依次为32．30％、31．72％；不同月份的阳性率以3月最低，8、9、10、11、12月份普遍较高，每月均高于30％。分离出的真菌经鉴定共有9属，以念珠菌属构成比最高（49．21％），曲霉菌属19-37％；共发现念珠菌94株，其中白色念珠菌排第1位，有63株，占67．02％；其次为热带念珠菌14株，占14．89％。结论海口地区眼部真菌感染多见于男性，以角膜炎患者感染多见。感染的真菌以念珠菌为主，此与国内其他地区不同，可能与本地区热带气侯有关。Objective To analyze the epidemiological and etiologic characteristics of ocular fungal infection in Haikou. Methods The samples of corneal, conjunctivae, anterior chambers, lacrimal sacs were taken from the outpatients and inpatients in the Department of Ophthalmology for ftmgal culture. The positivity rates of fungal culture were statistically analyzed to describe the seasonal and genus distribution of the fungal infections. Results A total of 683 patients were involved in this study, and the total positivity rate of fungal culture was 27.96%. The positivity rate was 33.42% in male patients and 21.52% in female patients （P〈0.01）. The positivity rates were 31.42%, 11.32%, 10.81%, 21.28% and 29.17% in the cornea, conjunctivae, anterior chambers, lacrimal sacs and other locations （P〈0.01）, and were 34.88%, 22.58%, 11.76%, 4.11%, 21.43% and 13.33% in farmers, workers, teachers, government officers, students and personnel of other occupations （X^2=39. 550, P=0.001）, respectively. In terms of age, the rate was 32.30% in 21-40 years group, 31.72% in 41-60 years group, 17.12% in over 60 years group and 26.61% in below 20 years group, showing significant differences （P〈0.01）. The rates were higher in August, September, October, December, November, all above 30%, but lower in March. Nine genera were identified, including Cand/a （49.21%）, Aspergillus （19.37%）, Fusarium （9.42%）, mucor （5.76%）, Actinomyces （5.24%）, Penicillium （3.66%）, Saccharomyces （2.62%）, non-spore group （1.57%）, Alternaria （1.57%）, and other genera （1.57%）. Among the 94 strains of Candia, 63 （67.02%） belonged to Candida albicans and 14 to Candida tropicalis （14.89%）. Conclusions Ocular fungal infection occurs more often in male patients and in the cornea. The common pathogen of ocular fungal infection is Canal/a, which is different from the etiological characteristics in other areas possibly in association with the tropical climate.

关 键 词：眼部 真菌 海口 念珠菌 

分 类 号：R181.3[医药卫生—流行病学]