首页|玻璃体腔注射治疗前结膜囊微生物培养阳性患者的临床及危险因素分析

玻璃体腔注射治疗前结膜囊微生物培养阳性患者的临床及危险因素分析

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目的 观察分析玻璃体腔注射治疗(IVT)前结膜囊微生物培养阳性患者的危险因素。方法 前瞻性临床研究。2021年2月至2024年2月于天津医科大学眼科医院玻璃体腔注药中心行IVT治疗的患者1 092例纳入研究。其中,男性539例,女性553例;年龄(62。29±13。61)岁。高血压、糖尿病分别为661、576例。居住地为城镇、乡村分别为742、350例。IVT前3、1 d给予抗生素点眼和未使用抗生素点眼各为364例。详细收集患者性别、年龄、高血压和糖尿病病史、IVT前抗生素滴眼液用药史、居住地差异(城镇/乡村)等。患者均于冲洗结膜囊后采集标本,并进行微生物培养。对比观察IVT前未使用抗生素点眼、IVT前1d点眼、IVT前3d点眼患者之间结膜囊微生物培养阳性率差异。观察不同年龄、不同性别、有无高血压、有无合并糖尿病、不同IVT次数、不同居住地(城镇/乡村)患者之间结膜囊微生物培养阳性率。不同临床基线者之间结膜囊微生物培养阳性率比较采用x2检验。影响因素分析采用logistic二元回归分析。结果 1092例患者中,结膜囊微生物培养共检出阳性54例(4。95%,54/1 092)。不同年龄(x2=5。599)、性别(x2=0。549)、居住地(x2=0。153)、有无高血压和(或)糖尿病(x2=3。545、0。044)、是否合并糖尿病黄斑水肿(x2=0。180)者之间结膜囊微生物培养阳性率比较,差异均无统计学意义(P>0。05)。不同IVT次数(x2=0。961)、IVT前不同时间抗生素点眼和未行抗生素点眼者(x2=5。600)之间结膜囊微生物培养阳性率比较,差异均无统计学意义(P>0。05)。logistic二元回归分析结果显示,上述因素均不是导致结膜囊微生物培养阳性的危险因素(P>0。05)。观察期内所有患者均未发生感染性眼内炎。结论 IVT前应用抗生素点眼,不是结膜囊微生物培养阳性的决定性因素。
Analysis of clinical and risk factors of positive conjunctival sac culture before intravitreal injection
Objective To observe and analyze the risk factors of positive conjunctival capsule microbial culture in patients with intravitreal injection treatment(IVT)before treatment.Methods A prospective study.A total of 1 092 patients who received IVT at the Vitreous Injection Center of Tianjin Medical University Eye Hospital from February 2021 to February 2024 were included in the study.Among them,539 were males and 553 were females.The age was(62.29±13.61)years.Hypertension and diabetes were 661 and 576 cases,respectively.There were 742 cases of urban residence and 350 cases of rural residence.Three and one days before IVT,364 patients received antibiotics and 364 patients did not receive antibiotics.Patients'gender,age,history of hypertension and diabetes,pre-IVT antibiotic eye drops use history,and differences in residence(town/country)were collected in detail.Samples were collected after the conjunctival sac was rinsed,and microbial culture was performed.The differences in conjunctival microbial culture positivity rates was compared between those who did not use antibiotic eye drops before IVT,those who used them 1 day before IVT,and those who used them 3 days before IVT.The positive rate of conjunctival sac microbial culture were compared among individuals of different ages,genders,with/without hypertension,with/without diabetes,with different IVT times,and from different living areas(urban/rural).The clinical baseline of positive conjunctival capsule bacterial culture was compared and observed.x2 test was used to compare the positive rate of conjunctival capsule microbial culture among different clinical baselines.Logistic binary regression analysis was used to analyze the influencing factors.Results Among the 1 092 patients,54 cases(4.95%,54/1 092)were positive for microbial culture of conjunctival sac.There was no significant difference(P>0.05)in the positive rate of conjunctival sac microbial culture among patients of different ages(x2=5.599),gender(x2=0.549),residence(x2=0.153),with or without hypertension and diabetes(x2=3.545,0.044),and with or without diabetic macular edema(x2=0.180).There was no significant difference(P>0.05)in the positive rate of conjunctival sac microbial culture between patients with different numbers of IVT(x2=0.961)or between those who received antibiotic eye drops before IVT and those who did not(x2=5.600).Logistic binary regression analysis showed that none of the above factors were risk factors for positive conjunctival capsule microbial culture(P>0.05).No infective endophthalmitis occurred in all patients during the observation period.Conclusion The use of antibiotics before IVT is not the decisive factor for positive microbial culture in conjunctival sac.

Intravitreal injectionConjunctival sac cultureInfectious endophthalmitisPerioperation

孙丽娜、栗勇涛、徐美琦、侯光华、柯屹峰、郑月、辛喜娜、Emmanuel Eric Pazo、任新军

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天津医科大学眼科医院、眼视光学院、眼科研究所国家眼耳鼻喉疾病临床医学研究中心天津市分中心天津市视网膜功能与疾病重点实验室,天津 300384

玻璃体腔注药 结膜囊微生物培养 感染性眼内炎 围手术期

2024

中华眼底病杂志
中华医学会

中华眼底病杂志

CSTPCD北大核心
影响因子:0.928
ISSN:1005-1015
年,卷(期):2024.40(12)