化脓性角膜炎患者病原菌与耐药性分析

Analysis of pathogens and drug resistance of suppaurative infective keratitis

目的探讨化脓性角膜炎患者的病原菌与耐药性,为临床治疗提供参考依据。方法选择医院2008年1月-2015年12月化脓性角膜炎患者292例(共300眼)作为研究对象,收集患者的临床资料、病原学检查结果及药物敏感实验结果。结果 292例化脓性角膜炎病因中,眼外伤118例占40.4%,配戴角膜接触镜21例占7.2%,眼部原有疾病28例占9.6%,全身性疾病29例占9.9%,眼部手术史9例占3.1%;246只眼进行了病原学检查,108只眼检出有病原菌,病原菌检出率为43.9%,12眼为真菌和细菌混合感染,96眼为单一致病菌感染,85只真菌性角膜炎眼中检出真菌37眼,检出率为43.5%,203例细菌性角膜炎眼中检出细菌59眼,检出率为29.1%;共检出108株病原菌,以革兰阳性菌为主,共40株占37.0%;表皮葡萄球菌对哌拉西林耐药率为91.3%,对红霉素的耐药率为82.6%;溶血性链球菌对氨苄西林的耐药率为83.3%,对红霉素的耐药率为66.7%,绿脓杆菌对红霉素的耐药率为100.0%,对氨苄西林的耐药率为86.4%。结论化脓性角膜炎的病原菌主要为表皮葡萄球菌和绿脓杆菌,两者的耐药性比较显著。

OBJECTIVE To explore the pathogens and drug resistance of suppaurative keratitis,so as to provide references for clinical treatment.METHODS A total of 292patients（300eyes）with suppaurative keratitis from Jan.y 2008 to Dec.2015 were selected as the study subjects.The clinical data,etiologic examination results and drug sensitivity test results were collected.RESULTS Among the 292 cases of suppaurative keratitis,there were 118 cases（40.4% ）with ocular trauma,21 cases with contact lens（7.2% ）,28 cases with eye diseases（9.6% ）,29 cases with systemic diseases（9.9% ）,and 9 cases with history of eye surgery（3.1% ）.Pathogens were detected from 108 eyes in 246 eyes,and the detection rate of pathogens was 43.9% .Totally 12 eyes were mixed infections of fungi and bacteria,and 96 cases were single pathogen infection.Fungi were detected from 37 eyes in 85 cases of fungal keratitis,with the detection rate of 43.5% ,and bacteria were detected from 59 eyes in 203 cases of bacterial keratitis,with the detection rate of 29.1% .Totally 108 strains of pathogens were detected,which were mainly40 strains of gram-positive bacteria,accounting for 37.0% .The resistant rate of Staphylococcusepidermidis to piperacillin was 91.3% ,and to erythromycin was 82.6% .The resistant rate of Hemolytic streptococcus to ampicillin was 83.3% ,and to erythromycin was 66.7% .The resistant rate of Pseudomonas aeruginosato erythromycin was 100.0% ,and to ampicillin was 86.4% .CONCLUSION The main pathogens of suppaurative keratitis are S.epidermidis and Pseudomonas aeruginosa,and the drug resistance is obvious.