Ayse İdil ÇAKMAK, Meryem ÇETİN, Yasemin ÖZ, Necip KARA

Güney Anadolu Üçüncül Göz Sağlığı Merkezinde Fungal Keratit Olgularının Demografik, Epidemiyolojik ve Etiyolojik Özellikleri

Güney Anadolu Doğu Akdeniz kıyısında yer alan üçüncü basamak göz sağlığı merkezimizde fungal keratit olgularının demografik, epidemiyolojik ve etiyolojik özelliklerini değerlendirmek. Mayıs 2017'den Mayıs 2019'a kadar görülen, kültürle kanıtlanmış tüm mantar keratitleri retrospektif olarak değerlendirildi. Olguların demografik özellikleri, predispozan faktörleri, ilişkili sistemik ve oküler özellikleri ve mikrobiyolojik analiz sonuçları incelendi. Fungal keratitli 15 olgunun ortalama yaşı 46±7 yıl (19-77 yıl arasında) idi ve erkek/kadın oranı 4:1 idi. Vakaların çoğunluğunu tarım işçileri veya çiftçiler oluşturuyordu (%73). Etyoloji ağırlıklı olarak çevre kaynaklı travmaydı (%93.3). Toplam 39 mikrobiyal pozitif kornea kültüründe 15 gözde (%38.5) mantar üremesi tespit edildi. Fusarium sp. dahil tüm vakalardan filamentöz mantarlar sorumlu olup 8 gözde (%53.3) Fusarium türleri ve 7 gözde (%46.7) Aspergillus türleri saptandı. Fusarium türleri F. Aquaeductus, F. Chlamydosporum, F. oxysporum ve F. solani olmak üzere 4 gözde; Aspergillus türleri ise 3 gözde A. niger ve A. flavus olarak belirlendi. İki gözde bakteriyel ve fungal koenfeksiyon gösterildi (Gram (+) beta hemolitik streptokokla beraber Aspergillus türü; Pseudomonas orzyihabitans ile beraber Fusarium türü). Güney Anadolu'nun Doğu Akdeniz kıyılarında karşılaşılan fungal keratit vakalarının özelliklerini belirleyen bu çalışmanın sonuçları, bu bölgede yaşayan hastaların hastalığın erken teşhisinde ve zamanında ve uygun ampirik tedavisinin başlanmasında faydalı olabilir.

Anahtar Kelimeler:

Fungal keratiti, oküler mikrobiyoloji, filamentöz mantarlar, fusarium, aspergillus

Demographic, Epidemiological and Etiological Characteristics of Fungal Keratitis Cases in Southern Anatolia Tertiary Eye Care Center

To evaluate the demographic, epidemiological and etiological characterisitics of fungal keratitis cases in our tertiary eye care center located in the Eastern Mediterraen coast of South Anatolia.A retrospective review of all culture-proven fungal keratitis seen from May 2017 to May 2019 was performed. The demographic features, predisposing factors, associated systemic and ocular characteristics, and microbiological analysis results of cases were evaluated. The mean age of 15 cases with fungal keratitis was 46±7 years (range: 19-77 years) with a male-to-female ratio of 4:1. The majority of the occupations of the cases were agricultural workers or farmers (73%). The etiology was predominantly trauma mostly with an environmental origin (93.3%). Fungal growth was detected in 15 eyes (38.5%) in a total of 39 microbial positive corneal cultures. Filamentous fungi were responsible for all cases, including Fusarium sp. in 8 eyes (53.3%) and Aspergillus sp. in 7 eyes (46.7%). Species of Fusarium were determined in 4 eyes, namely F. Aquaeductus, F. Chlamydosporum, F. oxysporum and F. solani; whereas species of Aspergillus were determined in 3 eyes, namely A. niger and A. flavus. Bacterial and fungal coinfection was shown in two eyes (Aspergillus sp. with Gram (+) beta hemolytic streptococcus; Fusarium sp. with Pseudomonas orzyihabitans). The results of this study, which determines the characteristics of fungal keratitis cases encountered in the Eastern Mediterranean coasts of Southern Anatolia may be useful in the early diagnosis of the disease, in the timely and appropriate empirical treatment of the patients living in this region.

Keywords:

Fungal keratitis, ocular microbiology, filamentous fungi, fusarium, aspergillus,

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