Analysis of causative genus of keratomycosis and antifungal susceptibility in tropical area of China

Authors: Chen Xiaolian,  Liu Hongshan,  He Hong,  Wu Jiaochan,  Hu Xianlyu,  Zhong Xingwu

DOI: 10.3760/cma.j.issn.2095-0160.2017.02.013
Published 2017-02-10
Cite as Chin J Exp Ophthalmol, 2017,35(2): 156-160.

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Hainan Island is a tropical and subtropical area in China, with a suitable climate for fungal growth and breeding.Keratomycosis occurred frequently in this area.It is essential to analyze the causative genus and investigate the sensitive drugs prior to the clinical treatment of fungal keratitis.


This study attempted to analyze the fungal population of fungal corneal ulcer patients in Hainan Island of China and examine the susceptibility of antifungal drugs.


A series cases observational study was carried out.One hundred and seventy-four eyes of 174 fungal corneal ulcer patients were enrolled in Hainan Eye Hospital from February 2014 to May 2016 based on the diagnosis criteria in Ophthalmology.The specimens at corneal lesions were collected under the aseptic conditions, and fungus was examined by KOH based smear.Mycological culture was performed with potato-dextrose agar and Sabourand’s agar.The 82 cultured causative strains were identified to characterize the spectrum of the species associated with keratitis infections in Hainan Province.Susceptibilities of these causative strains to ten antifungals were determined in vitro by slip diffusion method.


By smear microscopy, fungal hyphae and spores were found in 34 specimens of 126 patients, with the positive rate 27.0%.In 174 specimens of fungal culture, 82 strains of fungi were found, with the positive rate 47.1%, and typing results revealed that the isolates were distributed among species in the fusarium (47.5%), non-spore fungus (12.2%), aspergillus (9.8%) and phoma (9.8%). Nystatin was proved to be the most effective drug to 77 strains of antifungal drug susceptibility, followed by amphotericin B and terbinafine, with the susceptibility of 88.3%, 72.7%, and 71.4%, respectively.


Fusarium species, non-spore fungus, aspergillus, and phoma are common pathogenic fungi of keratomycosis around Hainan Island in China, and nystatin, amphotericin B and terbinafine are efficient in the treatment of the fungal corneal ulcer.

Key words:

Antifungal agents/pharmacology; Eye infections, fungal/microbiology; Keratitis/microbiology; Microbial sensitivity tests; Humans

Contributor Information

Chen Xiaolian
Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou 570311, China
Liu Hongshan
He Hong
Wu Jiaochan
Hu Xianlyu
Zhong Xingwu
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