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目的分析眼部真菌感染的菌属分布变化及其体外药敏试验。设计回顾性研究。研究对象北京市眼科研究所2005-2006年1246份眼部可疑真菌感染标本。方法标本接种于沙保罗培养基,在28℃、40%湿度环境下培养8-10天,并应用纸片法分析培养阳性真菌菌株对常用抗真菌药物的敏感性。主要指标菌属种类与季节分布;真菌菌株对那他霉素、特比萘芬、伊曲康唑、氟康唑、两性霉素B的敏感性。结果1246份标本中,真菌培养阳性330株(26.5%)。其中来自角膜、房水、玻璃体、结膜、睑板腺及其他眼组织的比例分别为92.4%、2.7%、1.5%、0.6%、1.0%、1.8%。培养阳性菌株72.4%分布在9月到次年2月,在3～8月者占27.6%。镰刀菌属占64.55%,曲霉属13.03%。对那他霉素、特比萘芬、伊曲康唑、氟康唑、两性霉素B的敏感性分别为88.18%、35.15%、11.82%、5.76%及33.64%。镰刀菌属对那他霉素最敏感,其次是特比萘芬和两性霉素B;曲霉属对特比萘芬最敏感,其次是两性霉素B和那他霉素。结论镰刀菌属和曲霉属是我国北方眼部真菌感染最主要的致病菌。绝大多数真菌菌株对那他霉素、特比萘芬和两性霉素B敏感,对伊曲康唑和氟康唑的耐药性较高。(眼科,2008,17:44-47)
Objective To analyze the distribution changes of fungi in eye fungus and the drug sensitivity test in vitro. Design retrospective study. Research object Beijing Eye Institute 2005-2006 1246 cases of eye suspicious fungal infection specimens. Methods The specimens were inoculated into sa Paulian medium and cultivated at 28 ℃ and 40% humidity for 8-10 days. The susceptibility of the tested positive fungal strains to common antifungal agents was analyzed by disk test. The main indicators of genus and season distribution; fungal strains of natamycin, terbinafine, itraconazole, fluconazole, amphotericin B sensitivity. Results Among the 1246 samples, 330 (26.5%) were positive for fungal culture. The proportions of corneal, aqueous humor, vitreous body, conjunctiva, meibomian gland and other ocular tissues were 92.4%, 2.7%, 1.5%, 0.6%, 1.0% and 1.8% respectively. 72.4% of the positive culture strains were distributed from September to February of the following year, accounting for 27.6% of the total from March to August. Fusarium accounted for 64.55%, Aspergillus 13.03%. The sensitivity to natamycin, terbinafine, itraconazole, fluconazole and amphotericin B were 88.18%, 35.15%, 11.82%, 5.76% and 33.64%, respectively. Fusarium is the most sensitive to natamycin, followed by terbinafine and amphotericin B; Aspergillus is the most sensitive to terbinafine, followed by amphotericin B and natamycin. Conclusion Fusarium and Aspergillus are the most important pathogens of ocular fungal infection in northern China. Most fungal strains are sensitive to natamycin, terbinafine and amphotericin B, and are more resistant to itraconazole and fluconazole. (Ophthalmology, 2008, 17: 44-47)