Pathogens diversity and in vitro drug sensitivity test in fungal keratitis
10.3760/cma.j.issn.1009-9158.2009.03.011
- VernacularTitle:真菌性角膜炎致病菌种的变迁及体外药物敏感试验研究
- Author:
Shiying SUN
;
Hualei ZHAI
;
Weiyun SHI
;
Jing ZHAO
;
Ge ZHAO
;
Lixin XIE
- Publication Type:Journal Article
- Keywords:
Keratitis;
Eye infections,fungal;
Microbial sensitivity tests
- From:
Chinese Journal of Laboratory Medicine
2009;32(3):282-286
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the distribution, diversity, and the sensitivity of common pathogen species to antifungal drugs in fungal keratitis during 2000 - 2006 in Shandong province. Methods Samples from corneal serapings and corneal buttons from keratoplasties were used for fungal culture and identification. The distribution and diversity of the pathogens in different years were analyzed. The sensitivity of some common species to antifungal drugs were tested. Results A total of 898 patients were diagnosed as fungal keratitis, in which 770 (85.7%) were positive in fungal culture. Pathogens in 748 cases caused by fungal infection were identified, of which 547 cases were caused by Fusarium (71.0%). The prevelence of Fusarium from 2000 to 2006 was 75.5%, 72.8%, 71.5%, 75.2%, 76%, 68. 8% and 56.4% respectively. Eighty-four cases were caused by Aspergillus( 10.9% ) , which accounted for 15.1% , 15.2% , 13.1%, 10. 2%, 10. 4% , 8.0% and 6. 9% of the cases from 2000 to 2006, respectively. Seventy-four eases were caused by Alternaria (9. 6% ), the percentage of which during 2000 -2006 was 1. 9%, 3.3%, 3.7%, 6. 6%, 8. 8%, 12. 0 and 29. 7% respectively. In genus Fusarium, 10 species were found and the most common species were Fusarium Solani ( 33. 8% ), Fusarium oxysporum ( 28.2% ) and Fusarium moniliforme( 27.4% ). Six species were identified in genus Aspergillus, with Aspergillus flavus (53.6%) and Aspergillus fumigatus (39.3% ) being the most common species. The geometric mean MICs of amphotericin B, terbinafin, itraconazole, 5-flucytosine and fluconazole against the common species were 0. 647, 0. 714, 1. 624, 15. 108 and 27. 070 μg/ml, respectively. The mean MICs of the above five antifungal drugs against Fusarium were 0. 899, 0. 893, 3.077, 37. 124 and 21. 687 μg/ml, respectively, and for Aspergillus, the mean MICs of these agents were 0.794, 0.591, 0.416, 23.973 and 7.127 μg/ml, respectively; for Alternaria,the MICs were 0. 409,0. 479,0. 433,11. 655 and 7. 104 μg/ml ,respectively. Conclusions Genus Fusarium, Aspergillus and Alternaria were the predominant pathogens in fungal keratitis in Shandong Province. During 2000 -2006, Fusarium was the most common one, followed by Aspergillus. The percentage of Aspergillus decreased annually. The third most common pathogen, Alternaria increased during the period. The geometric mean MICs of amphotericin B and terbinafin against Fusarium were lower than those of itraconazole, 5-flucytosine and fluconazole. The MICs of these five anti-fungal drugs against Aspergillus and Alternatia were lower than those for Fusarium.
