摘要
目的分析角膜后部即深基质或内皮层感染真菌对常用抗真菌药物的敏感性,为增强诊治方案的可行性提供参考依据。方法回顾性分析2013年5月-2018年5月在华中科技大学同济医学院附属梨园医院眼科进行治疗的、根据患者就诊时的病因选取角膜感染病灶位于深基质或内皮层且角膜上皮完整、角膜浅基质没有病灶的疑似真菌感染患者155例,对患者角膜标本刮取收集,进行病原真菌的分离培养,鉴定其真菌菌属,并采用纸片扩散法对不同菌属真菌进行四种抗真菌药物的敏感性分析。结果在疑似角膜后部真菌感染的155例患者真菌检查标本中,检出真菌53株,其中镰刀菌属检出率最高(28株)。镰刀菌属真菌对那他霉素敏感株数最多为23株,对氟康唑和伊曲康唑敏感株数为0,曲霉菌属真菌对那他霉素和特比奈芬的敏感株数分别为8株和10株;链隔孢霉属和假丝酵母属对那他霉素和特比奈芬敏感株数较多,对氟康唑和伊曲康唑敏感株数较少。结论镰刀菌属真菌对那他霉素敏感率最高,曲霉菌属、链隔孢霉属和假丝酵母属对特比奈芬的敏感率较高,几种病原真菌对氟康唑敏感率均较低。
OBJECTIVE To analyze the drug susceptibility of the patients with fungal infections in posterior parts of the cornea like deep matrix or endothelium so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 155 patients who had suspected fungal infection in deep matrix or endothelium with intact corneal epithelium and no corneal superficial lesions and were treated in department of ophthalmology of Liyuan Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from May 2013 to May 2018 were enrolled in the study and retrospectively analyzed.The corneal specimens were collected from the patients for the culture of pathogens,the isolated species of fungi were identified,and the antifungal agents susceptibility testing of the isolated fungi was performed for 4 types of antifungal agents.RESULTS Totally 53 strains of fungi were isolated from the corneal specimens of the 155 patients with suspected posterior corneal fungal infection,and the isolation rate of Fusarium spp(28 strains)was the highest.There were 23 strains of Fusarium spp that were susceptible to natamycin,and there was no strain that was susceptible to fluconazole and itraconazole.There were few strains of Aspergillus spp that were susceptible to natamycin(8 strain)and terbinafin(strains).There were many strains of Streptomyces and Candida spp tha were susceptible to natamycin and terbinafine,while there were few strains that were susceptible to fluconazole and itraconazole.CONCLUSION The drug susceptibility rate of the Fusarium spp to natamycin is the highest,the Aspergillus spp,Streptomyces spp and Candida spp are highly susceptible to terbinafine,and the drug susceptibility rates of the pathogenic fungi are low to fluconazole.
作者
黄萍
金慧瑜
杨涛
唐静
袁秀芝
HUANG Ping;JIN Hui-yu;YANG Tao;TANG Jing;YUAN Xiu-zhi(Liyuan Hospital Affiliated to Tongji Medical College Huazhong University of Science and Technology,Wuhan,Hubei 430070,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第22期3457-3460,共4页
Chinese Journal of Nosocomiology
基金
湖北省自然科学基金资助项目(2016CKB702)
关键词
真菌性角膜炎
角膜后部
抗真菌药
药物敏感性
Fungal keratitis
Posterior cornea
Antifungal agent
Drug susceptibility
