感染性眼病患者感染病原菌分布与耐药性研究

Distribution and drug resistance of pathogens causing infections in patients with infectious ophthalmopathy

目的探究感染性眼病患者感染病原菌分布与耐药性,为临床诊断与治疗提供依据。方法选取2012年1月-2016年12月医院接受治疗的2218例感染性眼病患者为研究对象,分析患者眼部标本病原菌分布并使用K-B纸片扩散法进行药敏试验。结果眼部标本2418份中阳性样本数733份,阳性率为30.31%,共培养病原菌733株,其中革兰阳性菌503株,革兰阴性菌111株,真菌119株;革兰阳性菌中表皮葡萄球菌和棒状杆菌分别为224株、119株;革兰阴性菌中铜绿假单胞菌59株;真菌中镰刀菌和曲霉菌分别为86株和21株;阳性标本主要来源于异物穿透、角膜溃疡、化学烧伤等引起感染的患者;葡萄球菌属对万古霉素、夫西地酸、左氧氟沙星、阿奇霉素的敏感率为100.00%、93.06%、85.22%、76.26%,棒状杆菌属对万古霉素、左氧氟沙星、庆大霉素、妥布霉素的敏感率为100.00%、93.12%、87.05%、91.03%。结论感染性眼病患者的病原菌以革兰阳性菌为主,大部分菌株对万古霉素、夫西地酸、左氧氟沙星等有较好的敏感性,临床治疗时可选择以上抗菌药物,提高感染性眼病患者的治疗效果。

OBJECTIVE To explore the distribution and drug resistance of pathogens causing infections in patients with infectious ophthalmopathy so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 2218 patients with infectious ophthalmopathy who were treated in the hospital from Jan 2012 to Dec 2016 were recruited as the study objects,the pathogens that were isolated from the eye site specimens were identified,and the drug susceptibility testing was performed by using K-B disk diffusion method.RESULTS Of the 2418 eye site specimens,733 were cultured positive,with the positive rate 30.31%.Totally 733 strains of pathogens were isolated,503 of which were gram-positive bacteria,111 were gram-negative bacteria,and 119 were fungi;there were 224 strains of Staphylococcus aureus and 119 strains of Corynebacteria among the gram-positive bacteria;there were 59 strains of Pseudomonas aeruginosa among the gram-negative bacteria;there were 86 strains of Fusarium and 21 strains of Aspergillus among the fungi.The positive specimens were mainly obtained from the patients with infections induced by foreign body penetration,keratohelcosis and chemical burns.The drug susceptibility rates of the Staphylococcus spp strains to vancomycin,fusidic acid,levofloxacin and azithromycin were 100.00%,93.06%,85.22% and 76.26%,respectively;the drug susceptibility rates of the Corynebacteria strains to vancomycin,levofloxacin,gentamicin and tobramycin were 100.00%,93.12%,87.05% and 91.03%,respectively.CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the patients with infectious ophthalmopathy,most of which are highly susceptible to vancomycin,fusidic acid and levofloxacin.It is necessary for the hospital to choose the above antibiotics for treatment of the patients with infectious ophthalmopathy so as to improve the curative effect.