角膜炎患者的常见病原菌类型观察与药敏分析

Observation of Common Pathogenic Bacteria Types and Analysis of Frug Sensitivity in Keratitis Patients

目的观察角膜炎患者常见病原菌类型并进行药敏分析。方法回顾性分析我院2013年2月至2017年2月收治的2856例角膜炎患者临床资料,收集眼部分泌物作为标本进行细菌培养,采用DL-96细菌鉴定系统进行药敏试验,分析角膜炎患者病原菌分布情况与药敏分析结果。结果 2856例标本细菌培养阳性560例,阳性率为19.61%,革兰阳性球菌占53.75%,包括表皮葡萄球菌、链球菌、微球菌。革兰阴性杆菌占26.43%,包括铜绿假单胞菌、大肠埃希菌、沙雷菌。革兰阴性球菌占9.29%,包括卡他莫拉菌、淋病奈瑟菌。革兰阳性杆菌占10.54%,包括化脓棒杆菌、分枝杆菌、诺卡菌。儿童患者中细菌性角膜炎阳性检出率最高,为23.67%,其次为老年患者,检出率为20.93%,青少年及成年患者检出率相对较低,分别为17.61%和16.05%;左氧氟沙星对众多病原菌均具有较高的耐药性,万古霉素对表皮葡萄球菌及链球菌的敏感度均较高,铜绿假单胞菌对阿米沙星敏感度较高。结论感染性角膜炎致病菌以表皮葡萄球菌感染为主,其次是铜绿假单胞菌与链球菌,临床治疗应明确病因,根据药敏试验合理用药,以降低耐药菌株的产生,有效控制病情,提高治疗效果。

Objective To investigate the common pathogenic bacteria types in keratitis patients and then analyze the drug sensitivity.Methods 2856 cases of keratitis patients in our hospital from February 2013 to February 2017 were retrospectively analyzed,collect the eye secretions as specimen for bacterial culture,DL-96 was used for drug sensitive test,analyze the pathogenic bacteria distribution and drug sensitivity result.Results In 2856 samples,positive 560 cases,positive rate 19.61%,gram positive coccus accounted for 53.75%,including staphylococcus epidermidis,streptococcus,micrococcus,gram negative bacilli accounted for 26.43%,including pseudomonas aeruginosa,escherichia coli,shewanella oneidensis,gram negative cocci accounted for 9.29%,including moraxella catarrhalis,neisseria gonorrhoeae,gram positive bacilli accounted for 10.54%,including corynebacterium pyogenes,mycobacteria,nocardiosis;children with bacterial coronitis had the highest positive detection rate（23.67%）,the next was senile patients（20.93%）,teenagers（17.61%） and adults（16.05%） had lower detection rates;levofloxacin had higher drug resistance of numerous pathogenic bacteria,vancomycin had higher sensitivity to staphylococcus epidermidis and streptococcus,pseudomonas aeruginosa had higher sensitivity to amikacin.Conclusion Pathogenic bacterium of infectious keratitis is mainly staphylococcus epidermidis,the next are pseudomonas aeruginosa and streptococcus,clinical treatment should determine the causes,take medicine reasonably,in order to lower the production of drug resistant strain,effectively control disease and improve treatment effect.