老年性白内障超声乳化吸出术使用的刀片及切口处细菌培养结果分析

Analysis of Microbial Culturing from Samples of Microkeratome Blade and Corneal Incision in Senile Phacoemulsification

目的:分析白内障超声乳化吸出术中使用的角膜穿刺刀片及切口处细菌培养及药敏试验结果,为手术前后合理使用抗生素提供依据。方法:选择100例行白内障超声乳化吸出及人工晶体植入术的老年性白内障患者,手术中所使用的角膜穿刺刀片搽拭棉签及角膜切口周边搽拭棉签各50个进行细菌培养,阳性者进一步行药物敏感试验。结果:50个刀片搽拭棉签和50个角膜切口搽拭棉签各有4个培养阳性,阳性率为8.00%,均为表皮葡萄球菌;8个培养阳性菌株对莫西沙星、达托霉素、左氧氟沙星、庆大霉素、四环素敏感率为100.00%(8/8)、100.00%(8/8)、87.50%(7/8)、87.50%(7/8)和62.50%(5/8),所有患者手术后3个月均无感染。结论:白内障超声乳化吸出术中使用的角膜穿刺刀片及切口处可培养出细菌,主要为表皮葡萄球菌,这些细菌对三、四代喹诺酮类抗生素以及脂肽类、氨基糖苷类抗生素等敏感。

Objective： To investigate the effect of the microbial culturing from samples of the microkeratome blade and corneal incision in phacoemulsification,in order to provide sound proof for reasonable usage of antibiotics. Method： A total of 100 patients who conducted phacoemulsification and posterial intraocular lens（ PIOLs） implantation were selected. A total of 100 samples were collected for bacterial culture,including microkeratome blade swabs and corneal incision swabs. Positive cultures were sent for minimal inhibitoryconcentration test（ MIT） and the results were analyzed. Results： Four positive results were obtained in 50 microkeratome blade cotton swabs and in 50 corneal incision swabs respectively,the positive rate was 8. 00%. Culturedbacteria was staphylococcus epidermidis in all positive samples. Sensitivity rates of 8 positive cultured samples to moxifloxacin,daptomycin,levofloxacin,gentamicin and tetracycline were 100. 00%（ 8 /8）,100. 00%（ 8 /8）,87. 50%（ 7 /8）,87. 50%（ 7 /8） and 62. 50%（ 5 /8） respectively. There were no endophthalmitis occurred during three months＇ postoperative period. Conclusion： Positive results are observed from samples of the microkeratome blade and corneal incision in phacoemulsification. The bacteria is mainly staphylococcus epidermidis,which is sensitive to aminoglycosides,third-and fourth-generation fluoroquinolones and the peptide antibiotics.