Spectrum of fungal keratitis in central China.
OBJECTIVE
To investigate the epidemiology, risk factors, fungal spectrum and to test antifungal drug susceptibility of these isolates at a tertiary eye care referral centre in central China.


METHODS
The medical and microbiology records of 2064 culture-proven cases (2064 eyes) of fungal keratitis diagnosed at Henan Eye Institute between January 2000 to March 2009 was retrospectively reviewed. The fungal isolates were identified and a subgroup of 103 isolates were subjected to drug susceptibility tests for amphotericin B, fluconazole and ketoconazole by broth microdilution method.


RESULTS
A total of 2064 cases of confirmed fungal keratitis were identified. The predominant fungal species isolated was Fusarium spp. followed by Aspergillus spp. Alternaria spp. were another most common fungi in central China. Fungal keratitis was more common among men. A large proportion of the patients were middle-aged adults, and most were farmers. Ocular trauma was a highly significant risk factor and vegetative injuries were identified as a significant cause for fungal keratitis. Greatest number of cases of fungal keratitis was higher between September and December. Fusarium was mostly sensitive to amphotericin B, next to ketoconazole. Aspergillus was sensitive to amphotericin B and ketoconazole. Relatively, both Fusarium and Aspergillus were insensitive to fluconazole.


CONCLUSIONS
Fusarium and Aspergillus are always the most isolated pathogens of fungal keratitis in central China, followed by Alternaria. Document available on the epidemiological features of a large series would greatly help ophthalmologists at primary and second health care centres in the management of this disease.
Wang
Liya
L
Henan Eye Institute, Zhengzhou, China. wangliya55@126.com
Sun
Shengtao
S
Jing
Yang
Y
Han
Lei
L
Zhang
Hongmin
H
Yue
Juan
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D000935:Antifungal Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D025141:Drug Resistance, Fungal; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007634:Keratitis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors
D000935:Antifungal Agents