300例角膜炎的细菌培养及药敏结果分析

Analysis of results of bacterial culture and drug sensitive test in 300 patients with keratitis

目的:针对专科医院的特色,了解和掌握细菌病原的分布和动态变化以及常见细菌药敏结果分析,对临床诊断与治疗均有重要指导意义。方法:对2010年1月至2011年9月在我院门诊及住院治疗、诊断明确的300例细菌性角膜炎患者进行回顾性分析。采集眼部分泌物,划线接种血平板按常规方法分离鉴定,并用K-B纸片琼脂扩散法做药敏实验。结果:细菌性角膜炎中常见的致病菌为革兰氏阳性球菌和革兰氏阴性杆菌,二者占97.7%。其中革兰氏阳性球菌中表皮葡萄球菌、金黄色葡萄球菌及链球菌占前三位;革兰氏阴性杆菌中铜绿假单胞菌和其他假单胞菌最多。300眼中手术治疗70眼,非手术治疗198眼,眼球摘除术32眼,出院时治愈191眼。结论:化脓性角膜炎是危害极大的致盲性眼病,细菌仍是主要致病菌,其预后与临床体征及病原种类有关,及早诊治和手术干预仍是挽救眼球的有力措施[1]。

Objective： To investigate the distribution and dynamic change of bacterial pathogens and analyze the results of drug sensitive test for common bacteria in a specialized hospital is very important clinical diagnosis and treatment. Methods： The clinical data of 300 patients with confirmed bacterial keratitis treated in our hospital from January 2010 to September 2011 were retrospectively analyzed. The eye secretion was collected, Then it wasisolated and identified with vaccination blood flat. The drug sensitive test was conducted with K-B paper AGAR diffusion method. Results： The common pathogens for bacterial keratitis were gram-positive cocci and gram- negative bacilli that account for 97.7%. For gram-positive cocci, staphylococcus epidermidis, staphylococcus aureus and streptococcus were the first 3. For gram-negative bacilli, pseudomonas aeruginosa and other pseudomonas were the most. For the 300 eyes, 70 received surgery, 198 eye non-operative treatment and 32 eyeball enucleation. Finally, 191 eyes were cured. Conclusion： Pyogenic keratitis is of the major reason for blind eye disease and bacteria are still the main pathogens. The prognosis and clinical signs of the disease is associated with the pathogenic species. Early diagnosis and surgical intervention is still an important means of saving eyeballs.