白内障术前结膜囊细菌培养及药物敏感性

Analysis of bacterial culture and antibiotics sensitivity tests results of conjunctival sac smears before cataract surgery

目的 观察白内障患者术前结膜囊细菌培养及药物敏感性.方法 随机抽取2010年1月至2012年12月在我院行白内障超声乳化手术患者420例（420只眼）,男性208例,女性212例,年龄55~95岁,平均78.23岁,其中老年性白内障386例,并发性白内障34例.术前对患者结膜囊进行细菌培养及药物敏感性试验.结果 420例患者中,结膜囊细菌培养阳性者120例,阳性率28.57%,70岁以下组细菌培养阳性率明显低于70岁以上组,两组比较,χ2=6.03,P＆lt;0.01,差异有显著性.术前结膜囊细菌阳性者,菌谱为：革兰阳性球菌102例,占85%,革兰阴性杆菌17例占14.14%,革兰氏阴性球菌1例,占0.83%;主要菌种有表皮葡萄球菌、金黄色葡萄球菌、溶血性链球菌等,大多数菌株对氧氟沙星、左氧氟沙星、妥布霉素、万古霉素等敏感.结论 白内障患者术前局部滴用氧氟沙星、妥布霉素、左氧氟沙星等有效抗生素,能预防白内障术后感染,增加手术安全性,降低手术风险.

Objective To observe the bacterial culture and antibiotics sensitivity tests Results of conjunctival sac smear before cataract surgery. Methods We randomly eheme 420 cataract patients who underwent phacoemulsifieation in our hospital from Jan 2010 to Dec 2012. There were 208 male and 212 female. Ages ranged from 55 to 95 years old with average at 78.23. Patients received age-related cataracts （ 386 cases ） or surgeries for complicated cataracts （ 34 cases ）. We analyzed the bacterial culture and antibiotics sensitivity test Results of eenjunctival sac smears before cataract operation. Results Bacterial culture was positive in 120 cases （28.57% ）. The positive rate of bacterial culture is significantly lower in the patients who were under 70 years old than in those were over 70 years old （X2 =6.03, P 〈0.01 ）. The species included Gram-positive cocci （ 102 cases, 85 % }, Gram-negative bacilli （ 17 cases, 14. 14% ）, and Gram-negative cocci （ 1 case, 0. 83 % ）. The top 3 common species were Staphylocoecous epidermidis, Staphylococcous aureus and hemolytic Streptococci. Most bacteria were sensitive to Ofloxacint Levcofloxacin, Tobramyein and Vancomycin. Conclusion The tropical use d antibiotics such as Ofloxacin, Levodloxacin, Tobramycin before cataract surgery can effectively prevent post- overafive infection, increase the surgery safety, and decrease the risk.