外伤性感染性眼内炎患者房水致病菌检测及药敏特征分析
Detection of pathogenic in aqueous humor caused by traumatic bacterial endophthalmitis and analysis of drug sensitivity characteristics
张春排 1丁莉娟1
作者信息
摘要
目的 探讨外伤性感染性眼内炎房水致病菌分布情况以及其药敏特征.方法 回顾性病例系列研究.分析2019年1月至2024年1月在周口市眼科医院就诊的外伤性感染性眼内炎39例(39眼)患者的临床资料,表面麻醉或球后麻醉下行前房穿刺取房水于血琼脂平板上进行细菌与真菌培养,纸片扩散法分析药物敏感性,并依据患者眼内炎症情况予以治疗.结果 依据患者眼内炎症情况对症治疗,主要包括头孢等抗菌药物治疗、玻璃体切除术以及眼球摘除或眼内容物摘除术.治疗后,39例眼内炎患者炎症均得到有效控制,其中有18例患者视力≥0.1,21例患者视力＜0.1.39例标本进行微生物培养,分离出的致病菌均为细菌,共55株.革兰阳性菌42株(42/55,76.36％),其中头孢哌酮对表皮葡萄球菌、枯草杆菌的敏感性分别为81.48％(22/27)和88.89％(8/9);环丙沙星对表皮葡萄球菌、枯草杆菌的敏感性分别为85.19％(23/27)和100.00％(9/9).革兰阴性菌13株(13/55,23.64％).其中头孢哌酮对铜绿假单胞菌、大肠杆菌的敏感性分别为71.43％(5/7)和75.00％(3/4);环丙沙星对铜绿假单胞菌、大肠杆菌的敏感性分别为85.71％(6/7)和100.00％(4/4).结论 外伤性细菌性感染性眼内炎患者房水致病菌以革兰阳性菌为主,常见革兰阳性致病菌对环丙沙星、头孢哌酮等抗生素较为敏感.
Abstract
Objective To investigate the distribution and drug susceptibility of pathogenic bacteria in aqueous humor caused by traumatic bacterial endophthalmitis.Methods This was a retrospective case series study.The clinical data of 39 eyes of 39 patients with bacterial traumatic endophthalmitis treated in Zhoukou Municipal Ophthalmic Hospital from Jan.2019 to Jan.2024 were analyzed.Aqueous humor was extracted from the anterior chamber by puncture under surface anesthesia or retrobulbous anesthesia and cultured on blood agar plate for bacteria and fungi.The drug sensitivity was analyzed by disk diffusion method,and the patients were treated subject to conditions of intraocular inflammation.Results Based on the intraocular inflammation conditions of the patients,the treatments included antibiotics application(such as cephalosporin),vitrectomy,and enucleation of eyeball eye contents.After symptomatic treatments,the inflammation of 39 patients with endophthalmitis was effectively controlled,of which 18 patients had visual acuity ≥0.1 and 21 patients had visual acuity＜0.1.A total of 39 samples were submitted for microbial culture,and 55 strains of bacteria were isolated.The sensitivity of cefoperazone to Staphylococcus epidermidis and Bacillus subtilis was 81.48％(22/27)and 88.89％(8/9),and the sensitivity of ciprofloxacin to Staphylococcus epidermidis and Bacillus subtilis was 85.19％(23/27)and 100.00％(9/9),respectively,among the 42 Gram-positive strains(42/55,76.36％).There were 13 Gram-negative strains(13/55,23.64％).The sensitivity of cefoperazone to Pseudomonas aeruginosa and Escherichia coli was 71.43％(5/7)and 75.00％(3/4),respectively.The sensitivity of ciprofloxacin to Pseudomonas aeruginosa and E.coli was 85.71％(6/7)and 100.00％(4/4).Conclusion Among the common pathogens,gram-positive bacteria and gram-negative bacteria are sensitive to ciprofloxacin,cefoperazone,tobramycin,cefzolin and gentamicin,and appropriate antibiotics can be selected for clinical treatment subject to the distribution of pathogenic bacteria and the results of drug sensitivity test.
关键词
眼内炎/眼外伤/感染/细菌性/药敏特征Key words
Endophthalmitis/Eye trauma/Infection/Bacterial/Drug sensitive characteristic引用本文复制引用
出版年
2024
NETL
NSTL
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