[Zhonghua yan ke za zhi] Chinese journal of ophthalmology · 2013
[Analysis of etiology and in vitro drug resistance of ocular fungal infection in period of 2009 - 2010].
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Zhang Yang, Wang Zhi-qun, Sun Xu-guang
Аннотация
OBJECTIVE: To analyze the distribution and shifting trends of fungal culture specimens and assess the drug sensitivity in vitro.
METHODS: Case series study. From January 2009 to December 2010, 1302 specimens were collected. These specimens were cultured on potato dextrose agar medium under 28°C and 40% humidity for 3 - 8 days. Drug sensitivity of positive cultures were evaluated by K-B method. Chi-square test was used for the analysis.
RESULTS: In 1302 specimens, 292 samples (22.4%) were culture-positive, in which 69.9% were isolated from the cornea, 3.8% from the vitreous body, 1.0% from the anterior chamber, 0.7% from the conjunctiva, 0.7% from palpebral margin and 24.0% from other parts of the eye. Culture-positive rate of 2009 and 2010 were 21.2% (135/637) and 23.6% (157/665) respectively with no statistically significant difference (χ(2) = 1.092, P = 0.296). Two peaks of culture-positive outcome appeared in May and November. Culture results showed that Fusarium sp. was the commonest pathogen (59.6%, 174/292), Aspergrium sp. in 16.8% (49/292) and Alternaria sp.in 10.6% (31/292). Patients from 31 to 60 years old accounted for 82.2% (240/292) of positive cases. The sensitive rate in vitro to natamycin, terbinafine, fluconazole, amphotericin B and itraconazole was 94.0% (63/67), 63.4% (154/ 243), 6.0% (17/285), 39.7% (98/247) and 21.2% (65/306), respectively.
CONCLUSIONS: The top three commonest fungus of Beijing Tong Ren hospital successively are Fusarium sp., Aspergrium sp. and Alternaria sp. Natamycin should be the first choice for fusarium infection and pathogen-unknown infection. All species with the exception of Fusarium sp. are sensitive to natamycin, terbinafine and amphotericin B but not itraconazole. Almost all fungal strains are resistant to fluconazole.
METHODS: Case series study. From January 2009 to December 2010, 1302 specimens were collected. These specimens were cultured on potato dextrose agar medium under 28°C and 40% humidity for 3 - 8 days. Drug sensitivity of positive cultures were evaluated by K-B method. Chi-square test was used for the analysis.
RESULTS: In 1302 specimens, 292 samples (22.4%) were culture-positive, in which 69.9% were isolated from the cornea, 3.8% from the vitreous body, 1.0% from the anterior chamber, 0.7% from the conjunctiva, 0.7% from palpebral margin and 24.0% from other parts of the eye. Culture-positive rate of 2009 and 2010 were 21.2% (135/637) and 23.6% (157/665) respectively with no statistically significant difference (χ(2) = 1.092, P = 0.296). Two peaks of culture-positive outcome appeared in May and November. Culture results showed that Fusarium sp. was the commonest pathogen (59.6%, 174/292), Aspergrium sp. in 16.8% (49/292) and Alternaria sp.in 10.6% (31/292). Patients from 31 to 60 years old accounted for 82.2% (240/292) of positive cases. The sensitive rate in vitro to natamycin, terbinafine, fluconazole, amphotericin B and itraconazole was 94.0% (63/67), 63.4% (154/ 243), 6.0% (17/285), 39.7% (98/247) and 21.2% (65/306), respectively.
CONCLUSIONS: The top three commonest fungus of Beijing Tong Ren hospital successively are Fusarium sp., Aspergrium sp. and Alternaria sp. Natamycin should be the first choice for fusarium infection and pathogen-unknown infection. All species with the exception of Fusarium sp. are sensitive to natamycin, terbinafine and amphotericin B but not itraconazole. Almost all fungal strains are resistant to fluconazole.