首页|老年外伤性感染性眼内炎患者临床特征、病原菌及耐药性分析

老年外伤性感染性眼内炎患者临床特征、病原菌及耐药性分析

Analysis of clinical features,pathogenic bacteria and drug resistance in elderly patients with traumatic infective endophthalmitis

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目的 探讨老年外伤性感染性眼内炎(PTIE)患者临床特征、病原菌及耐药性.方法 对 2023 年 1 月至2024 年 1 月本院就诊的 76 例(76 眼)老年PTIE患者进行回顾性分析,收集患者临床特征、病原菌,分析其耐药性.结果 老年PTIE临床特征与伤口位置为Ⅰ区(84.21%)、眼内异物穿通伤(60.52%)、眼内异物以金属异物(48.68%)有关,其中 75 岁以上的患者真菌检出率高于 60~75 岁患者(P<0.05);在 76 例老年PTIE患者中,共分离出 56 种病原菌,包括 45 种革兰氏阳性菌、8 种革兰氏阴性菌及 3 种真菌.革兰阳性菌中,表皮葡萄球菌耐药性最高为青霉素(100%)、庆大霉素(88.89%),腐生葡萄球菌耐药性最高为青霉素(88.89%)和红霉素(88.89%);在革兰阴性菌群体中,铜绿假单胞菌耐药性最高为阿米卡星(100%)与氨苄西林(100%),肺炎克雷伯菌耐药性最高为氨苄西林(100%).结论 老年PTIE患者病原菌分布受伤口位置、外伤类型、眼内异物类型和年龄因素影响,其中革兰阳性菌为主要感染类型,以表皮葡萄球菌最为常见.表皮葡萄球菌对青霉素具有较高的耐药特性,相比之下,对氨苄西林和亚胺培南的耐药程度则相对较低.
Objective To investigate the clinical features,pathogens and drug resistance of elderly patients with traumatic infective endophthalmitis(PTIE).Methods 76 elderly patients(76 eyes)with PTIE treated in our hospital from January 2023 to January 2024 were retrospectively analyzed.Clinical characteristics and pathogenic bacteria of patients were collected and their drug resistance was analyzed.Results The clinical features of elderly PTIE were related to the location of the wound in area I(84.21%),the penetration injury of intraocular foreign body(60.52%)and the presence of metal foreign body(48.68%).The fungal detection rate in patients who were above 75 years old was higher than that in patients 60~75 years old(P<0.05).In 76 elderly patients with PTIE,a total of 56 pathogenic bacteria were isolated,including 45 Gram-positive bacteria,8 Gram-negative bacteria and 3 kinds of fungi.Among Gram-positive bacteria,the highest resistance of Staphylococcus epidermidis was penicillin(100%)and gentamicin(88.89%),and the highest resistance of Saprophytic staphylococcus was penicillin(88.89%)and erythromycin(88.89%).Among Gram-negative bacteria,the highest resistance was amikacin(100%)and ampicillin(100%)in Pseudomonas aeruginosa,and ampicillin(100%)in Klebsiella pneumoniae.Conclusion The distribution of pathogenic bacteria in elderly PTIE patients was affected by the location of the injured mouth,the type of trauma,the type of foreign body in the eye and age factors,among which Gram-positive bacteria was the main infection type,Staphylococcus epidermidis was the most common.Staphylococcus epidermidis has a high resistance to penicillin,in contrast to ampicillin and imipenem are relatively low resistance.

senile traumatic infective endophthalmitisclinical featurespathogenic bacteriadrug resistance

高琛、李泉、陈涛、郑吉琦、冯玉沛、陈莉芸

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甘肃省康复中心医院眼科,兰州 730000

甘肃省康复中心医院检验科,兰州 730000

兰州市安宁区万里医院眼科,兰州 730070

老年外伤性感染性眼内炎 临床特征 病原菌 耐药性

2024

实验室检验
中国检验检测学会

实验室检验

ISSN:2097-261X
年,卷(期):2024.2(12)