目的：分析上饶市中心医院2020-2024年期间感染性眼病患者的病原菌分布特征，为临床精准防控并制定有效策略提供依据。

方法：回顾性分析2020年5月至2024年12月间临床送检的感染性眼病患者角膜、泪道、结膜及眼内液等微生物培养标本，进行病原学培养和鉴定。

结果：本研究最终纳入447例患者，其中男250例，女197例，年龄58.5±17.1岁。眼部标本447例中，培养阳性样本146例，阳性率为32.7%。在培养阳性样本中男性患者占比63.7%(93/146)； 51-70岁年龄段眼部感染患者数达60.3%(88/146)； 而农民工是眼部感染主要人群，占比95.9%(140/146)； 与其它致病原因相比，外伤是导致眼部感染的主要诱因(P<0.01)。眼部细菌感染中，革兰阳性球菌占61.2%，泪道、结膜、眼内以葡萄球菌为主，角膜以肺炎链球菌为主，革兰阴性菌以铜绿假单胞菌为主。真菌感染91.8%发生在角膜，镰刀菌属占45.9%为首要病原。

结论：眼部感染病原菌分布具有明显组织特异性，外伤是角膜真菌感染的主要诱因，临床应重视眼部外伤患者，特别是对从事农业劳动眼部感染患者尽早开展真菌检查。

METHODS: A retrospective analysis was carried out on clinical specimens including the cornea, lacrimal duct, conjunctiva, and intraocular fluid samples, from patients with infectious eye diseases between May 2020 and December 2024. All the specimens underwent microbiological cultures and identification.

RESULTS: A total of 447 patients enrolled ultimately in this study, including 250 males and 197 females, with an average age of 58.5±17.1 y. Among the 447 ocular specimens, bacterial infection was confirmed in 146 cases(32.7%). Of these positive samples, male patients accounted for 63.7%(93/146)and patients aged 51-70 y had the highest infection rate(88/146, 60.3%). Furthermore, migrant workers represented the predominant demographic affected by ocular infections, accounting for an overwhelming majority at 95.9%(140/146). When compared to other etiologies of disease, trauma emerged as the primary cause of ocular infections(P<0.01). In cases of bacterial ocular infections, Gram-positive cocci comprised approximately 61.2%, with Staphylococcus identified as the principal pathogen affecting the lacrimal duct, conjunctivae, and intraocular fluid. Streptococcus pneumoniae was found to be the main pathogen associated with corneal infections. Gram-negative bacteria were predominantly Pseudomonas aeruginosa. Fungal infections were observed in an alarming rate of 91.8% among corneal specimens. Fusarium was identified as the leading fungal pathogen responsible for these cases at a proportion of 45.9%.

CONCLUSION: The distribution of pathogenic bacteria causing ocular infections demonstrates obvious tissue specificity. Trauma is identified as a major inducement of corneal fungal infection. Clinically, it is essential to pay particular attention to patients with ocular trauma, especially those engaged in agricultural labor who present with ocular infections, and fungal tests should be conducted as early as possible.