Characteristics of In Vitro Culture and In Vivo Confocal Microscopy in Patients with Fungal Keratitis in a Tertiary Referral Hospital in Central China

被引:9
作者
Wang, Jia-Song [1 ]
Du, Ya-Li [1 ]
Deng, Nan [2 ]
Peng, Xi [1 ]
Wong, Hang [1 ]
Xie, Hua-Tao [1 ]
Zhang, Ming-Chang [1 ]
机构
[1] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Ophthalmol, Wuhan 430022, Peoples R China
[2] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Clin Lab, Wuhan 430022, Peoples R China
基金
中国国家自然科学基金;
关键词
Fungal Keratitis; In Vivo Confocal Microscopy; Fungal Culture; Fusarium; Aspergillus; Alternaria; LAMELLAR KERATOPLASTY; CARE CENTER; SPECTRUM; DIAGNOSIS; VORICONAZOLE; MANAGEMENT; PATTERNS; FEATURES; FUSARIUM; LONDON;
D O I
10.3390/microorganisms11020406
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Purpose: To investigate the characteristics of in vitro culture and in vivo confocal microscopy (IVCM) in patients with fungal keratitis (FK) presented in a tertiary referral hospital in central China. Methods: In this noncomparative retrospective study, patients with the diagnosis of FK between October 2021 and November 2022 were reviewed. An IVCM and fungal culture (corneal scraping specimens) were performed, and the characteristics were analyzed. Results: During October 2021 and November 2022, 85 patients were diagnosed with FK. From 63 culture-positive cases, 8 species of fungus were identified. The proportions of isolated fungal species were Fusarium and Aspergillus equally accounting for 33.3% (21 of 63), Alternaria 9.5% (6 of 63), Curvularia 6.3% (4 of 63), Scedosporium apiospermum 6.3% (4 of 63), Paecilomyces lilacinus 3.2% (2 of 63), Exserohilum 3.2% (2 of 63), and Candida 4.8% (3 of 63), respectively. In positive culture cases, IVCM was found to be positive for hyphae or spores in 61 of 63 patients (96.8%). Different fungal species had a variety of cultural characteristics and IVCM manifestations. Conclusions: In a tertiary referral hospital in central China, Fusarium species, Aspergillus species, and Alternaria species were the 3 most common isolated fungal pathogens, and the proportion of Aspergillus species was significantly higher than that in other regions of China. Careful lesion depth examination by IVCM and OCT should be taken before lamellar keratoplasty to avoid postoperative recurrence. Identifying the IVCM image and culture characteristics will facilitate rapid diagnosis and proper treatment, but IVCM cannot yet replace fungal cultures to distinguish between different fungal species.
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页数:11
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