华东地区某医院眼部标本涂片结果分析

Analysis of smear results of ocular specimens from a hospital in East China

目的分析华东地区某医院眼部标本涂片结果,以期对眼部感染性疾病的诊疗提供依据。方法该研究为回顾性研究,收集本院2014年6月~2019年9月眼部标本细菌涂片、真菌涂片,分别统计其阳性率及变化趋势,并与培养结果对比,计数资料的组间差异分析应用χ^(2)检验。结果收集眼部细菌涂片标本5206份,阳性标本792份,阳性率为15.21%;男性541/792例,女性251/792例;患者年龄0~94岁,平均年龄(46.91±22.21)岁;致病菌主要为革兰阳性球菌(89%)。眼部真菌涂片标本5345份,阳性标本463份,阳性率为8.66%;男性276/463例,女性187/463例;患者年龄1~94岁,平均年龄(56.32±14.98)岁。角膜组织刮片中细菌涂片及真菌涂片的阳性率分别为11.16%(357/3200)与12.32%(432/3507);玻璃体液中分别为22.61%(341/1508)和2.17%(29/1334);房水中分别为18.88%(94/498)和0.40%(2/504)。角膜组织刮片主要取自角膜炎患者,玻璃体液与房水标本主要取自眼外伤与眼内炎患者。真菌涂片阳性率秋季较高,而细菌涂片阳性率夏季较高。细菌涂片与培养诊断符合率为78.54%,真菌涂片与培养诊断符合率为90.77%,培养阳性率高于涂片(P<0.05)。结论本研究从涂片结果分析,一定程度上反映了眼部感染性疾病致病菌的分布特征、阳性率、易感人群,以及致病菌的变迁规律,有助于为临床诊断、治疗提供依据。

Objective To analyze the smear results of ocular specimens from a hospital in East China,so as to provide evidence for the diagnosis and treatment of ocular infectious diseases.Methods A retrospective study.The ocular smears from the Eye&ENT Hospital of Fudan University from June 2014 to September 2019 were collected.The positive rates and trends were analyzed and compared with the culture results.Chi-square test was used to analyze the difference between data groups.Results Bacterial smears from 5206 eye were collected and 792 were positive,with the positive rate 15.21%.Patients included 541/792 males and 251/792 females,and were aged from 0 to 94 years,with an average age of(46.91±22.21)years.The most common pathogenic bacteria was Gram-positive cocci(89%).Fungal smears from 5345 eye were collected and 463 were positive,with the positive rate 8.66%.Patients included 276/463 males and 187/463 females,and were aged from 1 to 94 years,with an average age of(56.32±14.98)years.The positive rates of bacterial smear and fungal smear were 11.16%(357/3200)and 12.32%(432/3507)in corneal tissue,22.61%(341/1508)and 2.17%(29/1334)in vitreous,18.88%(94/498)and 0.40%(2/504)in aqueous humor,respectively.Corneal specimens were mainly taken from patients with keratitis,and vitreous humor and aqueous humor specimens were mainly taken from patients with ocular trauma and endophthalmitis.The positive rate of fungal smears were higher in autumn,while the positive rate of bacterial smears were higher in summer.The accordance rate between bacterial smear and culture was 78.54%,and 90.77%between fungal smear and culture.The positive rate of culture was higher than smear(P<0.05).Conclusions This study based on smear shown the etiological results and positive rate distribution as well as the trends in ocular infectious diseases,which provided clinical evidence for the diagnosis and treatment of ocular infectious diseases.