真菌性角膜炎的病原菌鉴定和药物敏感性分析

摘要

Objective To investigate the pathogen species,drug susceptibility and epidemiological characteristics of fungal keratitis in Jilin province,which provide evidence for diagnosis and treatment of clinical infections.Methods Corneal scrapings from 256 patients of suspected fungal infections were collected.Pathogenic fungi were isolated and i-dentified,the drug susceptibility and epidemiological characteristics were analyzed.Results 182 cases were diagnosed as fungal keratitis.Positive rate of fungal culture was 71.1%.A total of 194 fungal strains were isolated.Fusarium spp. (47.0%)was the predominant pathogen,among them,Fusarium solani (32.0%)was the most common isolate.The infections tended to occur in autumn.The majority of patients were male,middle-aged and farmer.Most of them had corneal trauma and treated with medicine before.The main pathogens were sensitive to natamycin.Conclusion Fusari-um spp.,especially Fusarium solani was the predominant pathogen of fungal keratitis in Jilin province.Corneal trauma will increase during the harvest season in autumn,which easily cause the occurrence of fungal keratitis.And natamycin can be used as the preferred drug for the prevention and treatment of fungal keratitis.%目的：了解吉林省真菌性角膜炎的病原菌种类、药物敏感性及流行病学特征，为感染的诊治提供参考依据。方法收集256例疑似真菌感染患者的角膜刮片标本，进行病原真菌的分离、鉴定及药物敏感性检测，并分析流行病学信息。结果有182例患者被诊断为真菌性角膜炎，真菌培养阳性率为71．1％，共分离获得194株真菌菌株。病原菌以镰刀菌属（47．0％）为主，其中茄病镰刀菌最常见（32．0％）。该病多发生在秋季，以男性、中老年、农民居多。多数患者有外伤史和局部用药史。主要病原真菌对纳他霉素均敏感。结论吉林省真菌性角膜炎病原菌以镰刀菌，特别是茄病镰刀菌为主。秋季农忙时外伤机会增多，易引起真菌性角膜炎发生。纳他霉素可作为临床预防和治疗真菌性角膜炎的首选药物。