不同年龄段慢性感染性角膜炎的病因和病原学特征分析

Cause and pathogenic characteristics of chronic infective keratitis in different age groups

目的:探讨不同年龄段慢性感染性角膜炎的病因和病原学特征。方法:将我院2015-01/2017-12确诊为慢性感染性角膜炎患者89例89眼作为研究对象,根据年龄分为13～32岁组35例35眼、33～52岁组28例28眼、53～73岁组26例26眼,对其不同年龄段的发病病因和病原学特征进行回顾性研究。结果:三组患者在病因分布上差异无统计学意义(P=0.290);三组患者在微生物组成分布上差异无统计学意义(χ~2=0.258,P=1.000)。三组患者真菌感染导致的慢性感染性角膜炎发生率相较于其他致病微生物均较高;所有患者中,细菌感染培养阳性患者26例,其中表皮葡萄球菌50%、绿脓杆菌15%、唾液链球菌12%、肺炎链球菌8%、大肠埃希菌8%和淋病双球菌8%,绿脓杆菌和表皮葡萄球菌是阳性培养结果中常见的细菌菌株;在真菌菌种感染患者中24例为培养阳性,其中镰孢菌属46%、曲霉菌属17%、交链孢属21%、菌丝体(无孢菌)4%、青霉菌属4%和弯孢菌属8%,所有阳性患者中以镰孢菌属和交链孢属两种菌种较高。结论:感染性角膜炎在不同年龄段的发病原因没有显著差异,在病原学分布上主要以真菌感染为主,病原学特征上细菌以表皮葡萄球菌为主,而真菌以镰孢菌属为主,应加强对感染性角膜炎的早期预防和防范。

·AIM:To investigate the cause and the description of pathogenic characteristics of chronic infective keratitis in different age groups.·METHODS:Totally 89 patients(89 eyes)with chronic infective keratitis were diagnosed in our hospital from January 2015 to December 2017 were selected as the research objects and the cause of the disease and pathogenic characteristics of different age groups,including 13-32 years group(35 eyes in 35 patiens),33-52 years group(28 eyes in 28 patiens)and 53-73 years group(26 eyes in 26 patiens),were retrospectively studied.·RESULTS:There were no significant differences in the etiological distribution of patients in the three groups(P=0.290).There was no significant difference in the distribution of microbial composition among the three groups(X^2=0.258,P=1.000).The incidence of chronic infectious keratitis caused by fungal infection in the three groups was higher than that of other pathogenic microbes.In this study,26 cases were positive in bacterial culture,including Staphylococcus epidermidis(50%),Pseudomonas aeruginosa(15%),Streptococcus salivarius(12%),Streptococcus pneumoniae(8%),Escherichia coli(8%)and Neisseria gonorrhoeae(8%).Pseudomonas aeruginosa and Staphylococcus epidermidis were the common bacterial strains in the positive culture results.In the cultivation of fungal strains 24 were positive cultures including Fusarium(46%),Aspergillus(17%),Alternaria(21%),Mycelium(no spore,4%),Penicillium(4%)and Curvularia(8%).Two strains of Fusarium spp.and Alternaria spp.were high of all patients.·CONCLUSION:There were no significant differences in the etiology of infectious keratitis among different age groups.Fungal infection is the main pathogen in the distribution of pathogens,the bacteria were mainly Streptococcus epidermidis in etiological features but in fungi,Fusarium dominates.So early prevention and prevention of infective keratitis should be strengthened and early treatment should be given.