白内障术前结膜囊菌群分布和药敏试验研究

The Research about the distribution of conjunctival sac bacterial flora ＆ experiment of drug sensitivity before cataract surgery

目的探讨白内障术前结膜囊细菌种类和药物敏感情况，为临床用药提供依据。方法对白内障术前205例（205眼）结膜囊采集标本进行细菌培养，观察培养阳性的细菌对常用抗菌药物的敏感性变化。结果细菌培养阳性26例（26眼），阳性率为12．68％。白内障患者术前结膜囊主要细菌构成为革兰阳性球菌（96．15％），其中以表皮葡萄球菌为主（69．23％），其次为溶血性葡萄球菌、产色葡萄球菌、腐生葡萄球菌；革兰阴性杆菌为洋葱假单胞菌。大多数细菌对万古霉素、阿米卡星、替考拉宁、克林霉素、莫匹罗星、呋喃妥因、吗啉唑酮敏感，耐药性小于20％，普遍对氨苄西林、四环素、头孢西丁、苯唑西林、红霉素明显耐药（68．0％以上）。结论表皮葡萄球菌是白内障术前结膜囊存在的最常见条件致病菌，预防感染或抗感染可以选用阿米卡星、克林霉素、呋喃妥因等常用抗菌药物。

Objective To research the distribution of conjunctival sac bacterial flora ＆ experiment of drug sensitivity before cataract surgery, base on this research, provide the basis for clinical medication. Methods Collect Conjunctival sac of 205 eyes from 205 cases and make germiculture, observe the move- ment of positive Gram＇ s sensibility which effect by common antibacterial. Results There were 26 eyes with cultured positive Gram from 205 case, the ratio of positive was 12.68%. The preoperative conjunctival sac of cataract patients was mainly made up of Gram positive bacteria（96.15% ）, and most of them were Staphylococcus epidermidi（69.23% ）, there were also Staphylococcus haemolyticus, Staphylococcus chro- mogenes and Staphylococcus saprophyticus, Gram negative bacilli was the Pseudomonas cepaci. Most of grams were sensitive to Vancomycin, Amikacin, Teicoplanin, Clindamycin, Mupirocin, Furadantin and Morpholine trazodone, the tolerance was less than 20%, and they usually had higher tolerance to Cephalexin Penicillin, Tetracycline, Cefoxitin, Oxacillin and Erythromycin （more than 68% ）. Conclusion Staphylo- coccus epidermidis is the most common conditioned pathogen which exist in conjunctival sac before cataract surgery. We can choose common antibacterials such like Amikacin, Clindamycin, Furadantin for infection prevention or anti-infection.