某市化脓性角膜炎的致病菌分布和耐药性分析

The analysis of the pathogenic bacteria distribution and drug resistance in pyogenic keratitis in a city

目的了解聊城市化脓性角膜炎的致病菌分布和耐药性状况。方法 2010年8月至2011年11月,在该院采集角膜炎患者的角膜分泌物标本,进行致病菌的分离培养和鉴定,用K-B(Kirby-Bauer)法对致病菌做药物敏感度实验,并对结果进行分析。结果共分离致病菌407例(85.1%)。真菌191例(46.9%),占前3位的分别为:镰刀菌属138例(33.9%)、曲霉菌属23例(5.65%)、链格孢属10例(2.46%)。细菌216例(53.1%),细菌中革兰阳性菌101例(24.8%),占前3位的分别是表皮葡萄球菌34例(8.35%)、金黄色葡萄球菌15例(3.69%)、肺炎链球菌12例(2.95%);革兰阴性菌115例(28.3%),占前3位的分别是铜绿假单胞菌53例(13.0%)、大肠埃希菌9例(2.2%)、肺炎克雷伯杆菌6例(1.47%)。镰刀菌属对那他霉素的敏感率最高,表皮葡萄球菌对万古霉素全部敏感,铜绿假单胞菌对左氧氟沙星敏感率最高。结论镰刀菌属、铜绿假单胞菌、表皮葡萄球菌是聊城市化脓性角膜炎的主要致病菌,临床应根据细菌耐药情况合理用药。

Objective To know the distribution of pathogenic bacteria and drug resistance of suppurative keratitis in Liaocheng City.Methods From August 2010 to November 2011,corneal secretion of keratitis collection of patients was carried out in Liaocheng Guangming Ophthalmic Hospital.The separation of pathogenic bacteria cultivation and appraisal were also carried out.Then drugs sensitivity experiments on pathogenic bacteria were performed with K-B law and finally the results were analyzed.Results Pathogenic bacteria were separated 407 cases（85.1%）.Fungi 191 cases（46.9%）,the first three respectively：the sickle bacteria genera were 138 cases（33.9%）.Aspergillus species were 23 cases（5.65%）.Alternaria were 10 cases（2.46%）.Bacteria were 216 cases（53.1%）.Gram staining positive bacteria were 101 cases（24.8%）.The first three respectively：Staphylococcus epidermidis were 34 cases（8.35%）.Staphylococcus aureus were 15 cases（3.69%）,Streptococcus pneumoniae were 12 cases（2.95%）.Gram negative bacteria dyeing were 115 cases（28.3%）.The first three respectively：pseudomonas aeruginosa were 53 patients（13.0%）,Escherichia coli were 9 cases（2.2%）.Klebsiella pneumoniae were 6 cases（1.47%）.Natamycin was the most sensitive to the sickle bacteria genera,vancomycin were all sensitive to Staphylococcus epidermidis,levofloxacin was the most sensitive to pseudomonas aeruginosa.Conclusion The sickle bacteria genera and pseudomonas aeruginosa,staphylococcus epidermidis is purulent keratitis main pathogenic bacteria in Liaocheng,clinical cases should be based on bacteria resistance of rational drug use.