真菌性角膜溃疡的临床及真菌学研究

Clinical study and mycology study of fungal corneal ulcer

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。

Objective Discuss the transitions of pathogenic bacteria in fungal corneal ulcer and the drug susceptibilities to anti-fungal drugs which are commonly used in clinic.Methods Analyzed the 46 strains of pathogenic fungus which obtained from the cultivations of 57 patients who diagnosed with fungal corneal ulcer,and the sensitivities to antifungal drugs were tested.Results In the 57 samples of fungal corneal ulcer,hypha and spore were seen in 49 samples（positive rate was 85.96%）;pathogenic bacteria were grown in 46 samples（positive rate was 80.70%）,most of them are fusarium（56.52%）,aspergillus（39.13%） and mucor（4.35%）.46 strains of fungi were highly sensitive to itraconazole and amphotericin B.Conclusion The main pathogenic fungus of corneal ulcer are fusarium and aspergillus;most of them are sensitive to itraconazole and amphotericin B.