耐药葡萄球菌对眼科常用抗菌药物的体外敏感性研究

In vitro sensitivity of drug-resistant Staphylococcus to commonly used ophthalmic antibiotics

目的了解外伤性眼内炎中病原菌分布特点及主要致病耐药葡萄球菌对眼科常用抗菌药物的体外敏感性。方法收集2018年7月—2023年7月于绵阳市中心医院外伤性眼内炎患者样本中检测的136株细菌,进行细菌培养、细菌鉴定和药敏试验。结果136株细菌由革兰阳性菌(n=81)、革兰阴性菌(n=49)和真菌(n=6)组成。主要感染病原菌为金黄色葡萄球菌42株、表皮葡萄球菌18株;2种耐药葡萄球菌对左氧氟沙星、头孢唑林钠、妥布霉素和夫西地酸的最小抑菌浓度(MIC)差异较小(0.7~7.5μg·mL^(-1)),对克林霉素的MIC差异较大(2.5~500μg·mL^(-1))。耐药葡萄球菌对5种抗生素的敏感性均差异无统计学意义(均P>0.05)。5种眼用抗生素对耐药葡萄球菌的敏感率差异有统计学意义(P<0.05),其中头孢唑林钠和夫西地酸对耐药葡萄球菌的敏感率显著高于克林霉素、左氧氟沙星和妥布霉素。结论耐药葡萄球菌是外伤性眼内炎患者的主要感染病原菌,夫西地酸、头孢唑林钠对耐药葡萄球菌的抗菌活性优于妥布霉素、左氧氟沙星、克林霉素。

Objective To investigate the distribution characteristics of pathogenic bacteria in traumatic endophthalmitis and the in vitro sensitivity of major drug-resistant staphylococcus aureus to commonly used ophthalmic antibiotics.Methods A total of 136 bacterial strains detected from the patients with traumatic endophthalmitis at Mianyang Central Hospital from July 2018 to July 2023 were collected for bacterial culture,identification,and drug sensitivity test.Results Of the 136 strains,81 strains were gram-positive bacteria,49 strains were gram-negative bacteria and 6 strains were fungi.The main pathogenic bacteria were 42 strains of staphylococcus aureus and 18 strains of staphylococcus epidermidis.The minimum inhibitory concentration(MIC)differences of the two drug-resistant staphylococcus species to levofloxacin,cefazolin sodium,tobramycin and fusidic acid were relatively low(ranging from 0.7 to 7.5μg·mL^(-1)),while the difference in the MIC to clindamycin was significant(ranging from 2.5 to 500μg·mL^(-1)).There was no statistically significant difference in the sensitivity of drug-resistant staphylococcus species to the five antibiotics(P>0.05).However,there were statistically significant differences in the sensitivity rates of the drug-resistant staphylococcus species to the five ophthalmic antibiotics(P<0.05).Specifically,the sensitivity rates of the drug-resistant staphylococcus species to cefazolin sodium and fusidic acid were significantly higher than those to clindamycin,levofloxacin and tobramycin.Conclusion Drug-resistant staphylococcus aureus is the main pathogenic bacterium in patients with traumatic endophthalmitis.The antibacterial activities of fusidic acid and cefazolin sodium against drug-resistant staphylococcus aureus are superior to those of tobramycin,levofloxacin and clindamycin.