AIM: To explore the distribution of pathogenic bacterial genera in patients with fungal keratitis and to analyze the main factors affecting its clinical outcome.

METHODS: A prospective study was conducted. A total of 102 patients with fungal keratitis treated in our hospital from March 2018 to March 2021 were included in the study. They were treated with combined antifungal drugs therapy first, and surgery was performed if the drug treatment was ineffective. The distribution of the pathogenic bacteria genera and the surgical rate of patients with different pathogenic bacteria were analyzed through fungus culture before treatment, and patients were divided into cured(76 cases)and not cured(26 cases)groups according to their clinical outcome. The main factors affecting the clinical outcome of fungal keratitis were explored.

RESULTS: Among the 102 patients included, 74 patients(72.5%)had positive fungal test results, and 13 patients(12.7%)were treated by surgery due to the ineffective drug therapy. There were significant differences in the surgical conversion rate of patients affected by different pathogenic bacteria genera(P<0.05). The conversion rate of patients with Fusarium was significantly higher than that of other pathogenic bacteria. Compared with not cured group, cured group had shorter course of disease, less ulcer area, infiltration depth and hypopyon. Most of them lived in cities and towns, and most of the pathogenic bacteria were fungi other than Fusarium(P<0.05). Logistic regression analysis showed that the course of disease, ulcer area, infiltration depth, hypopyon, pathogenic bacteria and residence were the risk factors affecting clinical outcome(P<0.05).

CONCLUSION: The main pathogenic bacteria of fungal keratitis are Fusarium, Aspergillus, etc. The drug treatment effect of Fusarium is worse. The course of disease, ulcer area, infiltration depth, hypopyon, pathogenic bacteria and residence can affect the clinical outcome of fungal keratitis.