细菌性角膜炎病原菌及抗生素耐药性的变迁

Shifting trends of pathogenic bacteria and antibiotic resistance in bacterial keratitis

细菌性角膜炎是严重危害患者视力的眼部感染性疾病。不同国家或地区由于地理、气候等的不同,其致病菌和药敏谱不尽相同。了解和掌握细菌病原的分布和动态变化以及常见细菌耐药性的改变,对临床诊断与治疗均有重要指导意义。就国内外细菌性角膜炎的主要病原菌、危险因素、检出率及耐药性的变化做一综述。

Bacterial keratitis is a serious ocular infectious disease that often lead to severe visual disability.Many patients have a poor clinical outcome if appropriate management and therapy is not promptly initiated.The spectrum of bacterial keratitis can also be influenced by geographic and climatic factors.Recently,the widespread and inappropriate use of broad spectrum antibiotics has resulted in significant change of antibiotic resistance in bacterial keratitis.The phenomenon of increasing resistance to antibiotic therapy is a matter of urgent concern in China and worldwise.The initial management of bacterial keratitis should treat on local experience.But regional differences in bacterial keratitis mean that treatment guidelines developed locally will not be universally applicable.It is necessary for ophthalmologist to grasp global pathogen variation and antibiotic resistance.The pathogenesis,predisposing factors,detection rate and antibiotic resistance are reviewed.