真菌性角膜炎流行病学及病原学特征  

Epidemiological and etiological characteristics of fungal keratitis

作　　者：马莉莉[1] 乔妍 李太娇[1] 高秀华[1] 赵冉[1] MA Li-li;QIAO Yan;LI Tai-jiao;GAO Xiu-hua;ZHAO Ran(Affiliated Hospital of Jining Medical University,Jining,Shandong 272029,China)

机构地区：[1]济宁医学院附属医院眼科,山东济宁272029

出　　处：《中华医院感染学杂志》2025年第2期241-244,共4页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金青年项目(ZR2022QH167)。

摘　　要：目的探究真菌性角膜炎的流行病学特征及感染病原菌分布情况与药物敏感性,为真菌性角膜炎及早诊疗提供支持。方法选取2020年10月—2023年11月济宁医学院附属医院收治的真菌性角膜炎患者212例(212眼)作为研究对象。统计真菌性角膜炎患者流行病学特征,采集真菌性角膜炎患者角膜刮片分析病原菌分布情况及药物敏感性。结果212例真菌性角膜炎患者中男女比例为1.62:1,以男性为主;>40~60岁(50.94%)为患病高发年龄段;以农村、高中以下、体力劳动者、有明确植物性外伤史为主要患病人群;并以秋季患病居多,冬季次之。212例真菌性角膜炎患者共分离出真菌212株,以镰刀菌属(主要为茄病镰刀菌)和曲霉菌属(主要为烟曲霉菌)为主,链格孢菌属次之。镰刀菌属、曲霉菌属、链格孢菌属均对伏立康唑(耐药率分别为6.90%、3.08%、3.23%)、两性霉素B(耐药率分别为12.64%、13.85%、9.68%)、制霉菌素(耐药率分别为10.34%、13.85%、6.45%)较为敏感,均对氟康唑(耐药率分别为94.25%、93.85%、83.87%)较为耐药,镰刀菌属、曲霉菌属还对伊曲康唑(耐药率分别为90.80%、89.23%)耐药较为严重。结论真菌性角膜炎患者以男性、>40~60岁、农村、高中以下、体力劳动者、有明确植物性外伤史居多,主要发生于秋季;病原菌以镰刀菌属为主,镰刀菌属、曲霉菌属、链格孢菌属引发的真菌性角膜炎推荐使用伏立康唑、两性霉素B、制霉菌素药物。OBJECTIVE To explore the epidemiological characteristics of fungal keratitis and analyze the distribution and drug susceptibility of pathogens causing infections so as to provide guidance for early diagnosis and treatment of fungal keratitis.METHODS A total of 212 patients(212 eyes)with fungal keratitis who were treated in Affiliated Hospital of Jining Medical University from Oct.2020 to Nov.2023 were recruited as the research subjects.The epidemiological characteristics of the patients with fungal keratitis were statistically analyzed.The corneal scrapes were collected to observe the distribution and drug susceptibility of pathogens.RESULTS Among the 212 patients with fungal keratitis,the ratio of male to female was 1.62:1,dominated by the male.The disease was highly prevalent among the age group of 40 to 60 years old.The patients from rural areas,the patients with education background below senior high school,manual workers and the patients with definite history of plant trauma were the major populations.Autumn was the peak season,followed by winter.Totally 212 strains of fungi were isolated from the 212 patients with fungal keratitis,among which Fusarium(mainly Fusarium solani)and Aspergillus(mainly Aspergillus fumigatus)were dominant,followed by Alternaria.The drug resistance rates of Fusarium,Aspergillus and Alternaria to voriconazole were 6.90%,3.08%and 3.23%,respectively;the drug resistance rate to amphotericin B were 12.64%,13.85%and 9.68%,respectively;the drug resistance rates to nystatin were 10.34%,13.85%and 6.45%,respectively;the drug resistance rates to fluconazole were 94.25%,93.85%and 83.87%,respectively.The Fusarium and Aspergillus were highly resistant to itraconazole,and the drug resistance rates were 90.80%and 89.23%,respectively.CONCLUSIONS The male,population aged between 40 and 60 years old,people from rural areas,manual workers and people with definite history of plant history are the major populations with fungal keratitis.It is highly prevalent in autumn.Fusarium was dominant among the pa

关 键 词：真菌性角膜炎 致病原因 流行病学特征 病原菌 药物敏感性 

分 类 号：R772.2[医药卫生—眼科]