Analysis of bacteria in the conjunctival sac and its drug resistance in diabetic patients before intraocular surgery
OBJECTIVE To analyze the bacteria in the conjunctival sac and its drug sensitivity in diabetic patients before intraocular surgery.METHODS Totally 120 diabetic patients(120 eyes)with eye diseases who were sched-uled to receive intraocular surgery in the Third Affiliated Hospital of Qiqihar Medical University from November 2021 to November 2023 were enrolled in the diabetic group,and 120 patients with eye diseases but without diabe-tes(120 eyes)who planned to receive intraocular surgery during the same period were selected as the non-diabetic group.Conjunctival sac samples were collected prior to preoperative prophylactic antimicrobial drug treatment,and bacterial cultures,as well as drug sensitivity tests for commonly-used ophthalmic antibacterial drugs were per-formed.RESULTS Of the 120 conjunctival sac specimens in the diabetic group,68 cases were positive for bacterial culture,with a positive detection rate of 56.67％,and of the 120 conjunctival sac specimens in the non-diabetic group,35 cases were positive for bacterial culture,with a positive detection rate of 29.17％.In the diabetic group,the positive rates of conjunctival sacbacteria culture before intraocular surgery in patients with age＞60 years old and duration of diabetes＞8 years were 68.63％and 78.79％,which were significantly higher than those in pa-tients with age≤60 years old and diabetes duration ≤8 years(P＜0.05).In the diabetic group,of 120 conjuncti-val sac specimens,a total of 86 strains of gram-positive bacteria were detected,mainly Staphylococcus epidermi-dis and Corynebacterium,and 32 strains of gram-negative bacteria were detected,mainly Acinetobacter lwoffii.Multiple infections were detected in 28 specimens.The drug resistance rate of Staphylococcus epidermidis to nor-floxacin in the diabetic group was the highest(47.83％),followed by erythromycin(43.48％)and gentamicin(39.13％),and the drug resistance rate to vancomycin was lower(4.35％).The drug resistance rates of Staphy-lococcus epidermidis to most antibacterial drugs in the non-diabetic group were relatively low,and the drug resist-ance rate to vancomycin was the lowest(3.57％).The drug resistance rate of Corynebacterium to gentamicin in the diabetic group was the highest(50.00％),followed by erythromycin(42.86％)and norfloxacin(42.86％).Corynebacterium in the non-diabetic group had a low rate of resistance to most antibacterial drugs,and was partic-ularly sensitive to ceftazidime,tobramycin and vancomycin.CONCLUSIONS The positive rate of conjunctival sac bacteria before intraocular surgery was higher in diabetic patients than in non-diabetic patients,and was more pro-nounced in the elderly and patients with a longer duration of diabetes.The bacteria were predominantly gram-posi-tive,with Staphylococcus epidermidis and Corynebacterium being the most common.Gram-negative bacteria were dominated by Acinetobacter lwoffii,and the main bacteria showed multi-drug resistance.
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