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不同年龄段健康人结膜囊菌群分布及抗生素敏感性分析

Distribution of conjunctival sac flora and antibiotic susceptibility in healthy people of different ages
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摘要 目的 了解不同年龄段健康人结膜囊菌群分布特征和抗生素敏感情况。方法 对2018年至2021年山东第一医科大学附属青岛眼科医院就诊的1 131例无感染性眼部疾病人群的1 839份结膜囊分泌物样本进行回顾性分析。并根据年龄将人群分为4组:儿童组(≤18岁)、青年组(>18~45岁)、中年组(>45~65岁)和老年组(>65岁)。采用χ^(2)检验或Fisher确切概率检验分别比较各组间结膜囊菌群分布及抗生素敏感性的差异。两两比较采用Bonferroni法进行。结果 研究人群年龄为1个月~91岁(中位数11.00岁,四分位数5.00岁、40.00岁),结膜囊细菌总检出率为64.93%;其中儿童组的细菌检出率(76.79%)显著高于青年组、中年组和老年组(均为P<0.001);表皮葡萄球菌(55.97%)、金黄色葡萄球菌(8.60%)和缓症链球菌(7.52%)是结膜囊最常见的三种细菌;革兰阳性菌对青霉素类(16.79%~53.47%)、大环内酯类(17.21%~20.87%)抗生素大多耐药,对万古霉素(99.56%)和加替沙星(98.57%)具有较高的敏感率;革兰阴性菌对头孢菌类抗生素(41.38%~80.00%)的敏感率较低,而对氨基糖苷类的阿米卡星(90.48%)和氟喹诺酮类抗生素(90.91%~97.73%)敏感;眼科常见抗生素中,儿童组对夫西地酸的敏感率最差,为54.55%,明显低于其他3组(均为P<0.001);加替沙星在不同年龄段人群及不同革兰染色菌中敏感率均超过90%,总敏感率高达98.44%。结论 表皮葡萄球菌是各年龄段健康人群结膜囊最常见的细菌。加替沙星无论是在不同年龄段人群还是在不同革兰染色菌中均普遍敏感,可考虑作为眼科围手术期经验性抗生素的首选用药。 Objective To characterize the distribution of conjunctival sac flora and antibiotic susceptibility in healthy people of different ages.Methods Totally 1839 conjunctival sac secretion samples from 1131 people without infectious eye diseases attending Qingdao Eye Hospital of Shandong First Medical University from 2018 to 2021 were retrospectively analyzed.These people were divided into four groups according to age:children(≤18 years old),young(19-45 years old),middle-aged(46-65 years old),and elderly(>65 years old).Differences in the distribution of conjunctival sac flora and antibiotic susceptibility among these groups were compared using the chi-square test or Fisher’s exact test.The Bonferroni method was used for pairwise comparisons.Results The total bacterial detection rate of the conjunctival sac in the study population aged 1 month to 91 years old(median:11.00 years old;quartiles:5.00 years old,40.00 years old)was 64.93%;the bacterial detection rate in the children group(76.79%)was significantly higher than that in the young,middle-aged and elderly groups(all P<0.001).Staphylococcus epidermidis(55.97%),Staphylococcus aureus(8.60%)and Streptococcus mitis(7.52%)were the most common bacteria in the conjunctival sacs.Gram-positive bacteria were resistant to most penicillins(16.79%-53.47%)and macrolides(17.21%-20.87%)antibiotics,and highly susceptive to vancomycin(99.56%)and gatifloxacin(98.57%).Gram-negative bacteria had low susceptibility rates to cephalosporin(41.38%-80.00%)antibiotics and were susceptive to amikacin(90.48%)and fluoroquinolone(90.91%-97.73%)antibiotics.Of the common antibiotics used in ophthalmology,the susceptibility rate of fusidic acid was the worst in the children group(54.55%),which was significantly lower than the other three groups(all P<0.001).Gatifloxacin had a susceptibility rate of more than 90%in different Gram-stained bacteria in all groups,with an overall sensitivity rate of 98.44%.Conclusion Staphylococcus epidermidis is the most common bacteria in the conjunctival sac in healthy people of all ages.Gatifloxacin is generally susceptive in different Gram-stained bacteria in people at different ages,and may be considered as the first choice for perioperative empiric antibiotics in ophthalmology.
作者 梁倩 夏甜 荆丽丽 元静 黄钰森 LIANG Qian;XIA Tian;JING Lili;YUAN Jing;HUANG Yusen(Qingdao University,Qingdao 266000,Shandong Province,China;Qingdao Eye Hospital Affiliated to Shandong First Medical University,Qingdao 266000,Shandong Province,China)
出处 《眼科新进展》 CAS 北大核心 2023年第12期958-963,共6页 Recent Advances in Ophthalmology
基金 国家自然科学基金项目(编号:81970788,82171027)。
关键词 年龄 结膜囊 细菌 抗生素敏感性 age conjunctival sac bacteria antibiotic susceptibility
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