Fungal keratitis in Saint Petersburg, Russia

Ref ID: 19177

Author:

T.S. Bogomolova, O.N. Pinegina, G.A. Chilina, E.V. Skryabina, T.N. Belyaeva, N.V. Vasilyeva, N.N. Klimko

Author address:

St. Petersburg, RU

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Objectives: To study etiology, risk factors and treatment outcomes in patients with fungal keratitis.
Methods: Diagnosis of fungal keratitis was established by direct fluorescent microscopy and culture of corneal scrapings obtained from patients with clinical symptoms of keratitis. Species identification was preliminary based on morphological and physiological characteristics of fungi and confirmed by DNA sequencing.
Results: During 2007-2012 yy. 24 cases of fungal keratitis were revealed in Saint Petersburg, Russia. Men to women ratio 1:1, age range 23 – 61. Main risk factors were trauma (16), contact lenses use (5), herpes virus infection (1), demodexosis (1), and chronic blepharoconjunctivitis (1).
At direct microscopy of corneal scrapings the following fungal elements were found: septated hyaline hyphae (16), yeast cells and pseudohyphae (6), and septated brown hyphae (2). In two cases sporulating structures of moulds also were detected by direct microscopy.
Culture was positive in 67% of cases. The etiologic agents of keratitis were: Fusarium spp.
( 4 ), Acremonium spp. (2), Penicillium spp. (2), Aspergillus flavus (2), Aspergillus fumigatus (1), Paecilomyces marquandii (1), Cladosporium sphaerospermum (1), Candida parapsilosis (3), and Candida albicans (1).
The patients received topical (natamycin, amphotericin B,) and systemic (voriconazole, amphotericin B, fluconazole) antifungal therapy in combination with surgical treatment. Clinical improvement was observed in all patients.
Conclusion: Hyaline molds were the most frequent etiologic agents of fungal keratitis in Saint Petersburg, Russia (70%) followed by Candida spp. (24%) and dematiaceous fungi (6%). Main risk factors for fungal keratitis were trauma of the eye and contact lenses use. Combination of antifungal drugs and surgery is effective treatment of fungal keratitis.

Abstract Number: P1062

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=163896&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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