Canine and Feline Ulcerative Keratitis in Taiwan

台灣地區犬貓潰傷性角膜炎之臨床及實驗室診斷分析

林中天(Chung-Tien Lin) ； 李佳霖(Jia-Lin Lee)

《臺灣獸醫學雜誌》 28卷2期 (2002/06) Pp. 106-112

https://doi.org/10.7009/TVJ.200206.0106

摘要

潰瘍性角膜炎是犬貓最常見的眼科疾病之一。本篇介紹利用眼科檢查雙眼式裂隙燈、角膜螢光染色、淚液產量測試、鼻淚管檢查及微生物培養來評估潰瘍性角膜炎患犬及患貓眼睛病型的情形。我們分析並統計90隻犬、20隻貓共110個確診為潰瘍性角膜炎動物之臨床及實驗室之診斷方式及診斷結果。分析的結果並和國外相關的文獻作比較。在這些病例之分析結果發現，患有潰瘍性角膜炎的犬及貓性別比例不同，但年齡分布並無差異。在犬方面，雄雌比例為2 : 1，年齡分布則以4-8歲佔53%、小於1歲佔18%兩個年齡層為最高，在貓雄雌比例為1:4，年齡主要分布在4-8歲佔53%、小於2歲佔32%兩個年齡層。潰瘍性角膜炎好發的犬種包括：西施（28%）、混種犬、瑪爾濟斯及約克夏等。在貓則以波斯貓（55%）最常見。引起潰瘍性角膜炎的原因包括：無明確原因（37%）、毛髮或睫毛生長異常（20%）及乾眼症（17%）。在感染性潰瘍性角膜炎之病例，微生物培養的結果以葡萄球菌及綠膿桿菌分離出之比例最高。在抗生素感受性試驗方面，治療分離出來之革蘭氏陽性菌以amoxicillin/clavulanic acid及cephasporin最有效，對ampicillin及lincomycin最具抗藥性；對革蘭氏陰性菌則以polymyxin B及tobramycin效果較佳，對neomycin、erythromycin及streptomycin具抗藥性。其它較常用於眼睛感染的抗生素，例如gentamicin及chloramphenicol則對病例具中等以上的抗藥性。綜合上述結果可知，在台灣地區之眼科感染或發炎犬貓對治療常用的抗生素已具普遍或甚至嚴重的抗藥性，故慎選及正確使用抗生素治療眼部疾病，為目前臨床診療之當務之急。

關鍵字

抗生素感受性試驗 ； 貓 ； 犬 ； 角膜潰瘍 ； 角膜 ； fluorescein螢光染色 ； 微生物培養 ； Shirmer試淚液試驗 ； 潰瘍性角膜炎

並列摘要

Ulcerative keratitis is one of the most common ophthalmic disorders in dogs and cats. The clinical and laboratory diagnosis of 110 cases of ulcerative keratitis including 90 dogs and 20 cats were studied and reviewed. The diagnosis and assessment of ocular lesions were based on clinical signs, slit-Iamp biomicroscope, fluorescein staining, Shirmer's tear test, examination of nasolacrimal system, and swabs for microbiological cultures. The cases of ulcerative keratitis in this study showed several characteristics compared with previous literatures. The sex distribution between affected dogs and cats was distinct, while the age distribution was similar between affected dogs and cats. In canine cases, the males to females ratio was approximately 2:1 and two peak affected age ranges were 53% of 4-8 years old and 18% of one year old or younger. In contrast, in affected cats, the males/females was 1:4 and the predominantiy affected ages were 53% of 4-8 years old and 32% of younger than 2 years old . The leading affected breeds were Shih Tzus (28%), Mongrels, Malteses, and Yorkshire terriers in the dog, while Persian (55%) was the predominantly affected feline breed. The leading causes were idiopathic (37%), hairs/lashes abnormalities (20%), and keratoconjunctivitis sicca (17%). In microbiological cultures from specimens of infected keratitis, Staphylococcus spp. and Pseudomonas spp. were leading pathogens in both canine and feline cases. Antimicrobial susceptibility tests were based on results of microbiological cultures and revealed that amoxicillin/clavulanic acid and cephasporin were effective against most Gram-positive bacteria isolated and polymyxin B and tobramycin were effective against most Gram-negative bacteria. On the other hand, the tests showed that most Gram-positive bacteria were resistant to ampicillin and lincomycin. Besides, most Gram-negative bacteria were resistant to neomycin, erythromycin, and streptomycin in these cases. Other commonly used ophthalmic antibiotics such as gentamicin and chloramphenicol showed variable efficacy or moderate bacterial resistance in our ulcerative keratitis cases. The bacteria isolated from the infected eyes showed high resistance to several commonly used ocular antibiotics and high percentage of Pseudomonas spp. infection Therefore, careful selection and use of antibiotics for treating infected animal eyes in Taiwan is critically important and advocated.

並列關鍵字

Antimicrobial susceptibility test ； Cat ； Corneal ulcer ； Dog ； Fluorescein staining ； Microbiological culture ； Shirmer's tear test ； Ulcerative keratitis