眼科感染病原菌的分布及耐药性调查

Distribution and drug resistance of bacteria causing ophthalmic infection

目的探讨眼部感染的主要病原菌分布及药物敏感性变化情况,指导临床医师合理选择抗菌药物。方法对2009-2010年住院患者分离的240例眼部标本的病原菌鉴定及药物敏感性试验进行回顾性分析。结果检出病原菌97株,检出阳性率为40.41%,阳性菌株中以革兰阳性球菌为主,其中表皮葡萄球菌25株占25.8%,金黄色葡萄球菌14株占14.4%;体外药物敏感试验发现,感染菌株中革兰阳性菌株对环丙沙星、左氧氟沙星、万古霉素、利奈唑胺等敏感率均>50.0%,而对红霉素、青霉素等敏感率均<30.0%;而革兰阴性菌中,以非发酵菌为主,对阿米卡星、妥布霉素、环丙沙星、哌拉西林/他唑巴坦、亚胺培南、美罗培南敏感率均>65.0%,真菌主要以曲霉菌属为主。结论掌握眼部感染病原菌的分布,对预防和控制眼部感染,合理使用抗菌药物,做好抗菌药物的宏观管理,遏制耐药菌的产生具有重要意义。

OBJECTIVE To investigate the species distribution and drug-resistance of bacteria in infective ophthalmic disease in our hospital,to direct the doctor reasonably use the antibacterial agents.METHODS Bacteria identification and drug sensitivity test to 240 strains separated from eye specimens of hospitalized patients were retrospectively analyzed during 2009-2010.RESULTS The number of positive cultures was 97,the positive rate was 40.41%.The Gram-positive bacteria was the most bacteria in the positive strains.There were 14 strains Staphylococcus aureus,25 strains Staphylococcus epidermidis,accounting for 14.4% and 25.8%,respectively.In vitro drug sensitivity tests show that the Gram-positive strains was more sensitive to the ciprofloxacin,levofloxacin,vancomycin and linezolid,all of which were above 50.0%.They were less sensitive to erythromycin and penicillin,which were below 30.0%.However,in the Gram-negative strains,most of them were non-fermentative bacteria,which were more sensitive to amikacin,tobramycin,ciprofloxacin,piperacillin/tazobactam,imipenem and meropenem,all of which were above 65.0%.In the fungal culture specimens,most of them were aspergillus.CONCLUSION Mastening the bacteria distribution of the eye specimens,reasonal usage of antimicrobial by eye infections show great significance to decnease the resistant pathogens.