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Fungal keratitis in Iran: Risk factors, clinical features, and mycological profile

Mohammad Soleimani1, Alireza Izadi2,3, Sadegh Khodavaisy4

  • 1Department of Ocular Trauma and Emergency, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Frontiers in Cellular and Infection Microbiology
|February 16, 2023
PubMed
Abstract

Insights

Ocular trauma from plant materials is a key risk factor for fungal keratitis (FK) in Iran. Understanding local fungal species and their antifungal susceptibility is crucial for effective FK management.

Area of Science:

  • Ophthalmology
  • Medical Mycology
  • Infectious Diseases

Background:

  • Fungal keratitis (FK) poses a significant threat to vision, particularly in agricultural regions.
  • Identifying local etiological agents and their resistance patterns is vital for effective treatment strategies.

Purpose of the Study:

  • To investigate the clinical characteristics and predisposing factors of FK.
  • To perform molecular identification of fungal isolates.
  • To determine the antifungal susceptibility profiles of causative agents in Tehran, Iran.

Main Methods:

  • A cross-sectional study was conducted from April 2019 to May 2021.
  • Fungal isolates were identified using conventional methods, confirmed by DNA-PCR, and yeasts by MALDI-TOF.
  • Antifungal susceptibility testing was performed using the EUCAST microbroth dilution method.

Main Results:

  • Fungal etiology was confirmed in 7.23% of corneal ulcers.
  • Ocular trauma involving plant materials was a significant predisposing factor.
  • The most common isolates were *Fusarium* spp. (39.5%), *Aspergillus* spp. (32.5%), and *Candida* spp. (16.2%).

Conclusions:

  • Amphotericin B is suggested for *Fusarium*-induced FK, while *Candida* FK can be treated with various agents including flucytosine and voriconazole.
  • FK in Iran is often linked to agricultural activities and ocular trauma.
  • Tailoring treatment based on local etiological and susceptibility data is essential for better FK management.
Keywords:
AspergillusFusariumIranantifungal susceptibilityfungal keratitisrisk factors

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