Watanabe K, Numata-Watanabe K, Hayasaka S
Department of Ophthalmology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Ophthalmic Res. 2001 May-Jun;33(3):136-9. doi: 10.1159/000055659.
We evaluated the existence of methicillin (DMPPC)-resistant staphylococci and ofloxacin (OFLX)-resistant bacteria among preoperative patients at an eye clinic. Bacterial growth was studied in 194 conjunctival specimens of 125 preoperative patients without signs of ocular infection. Specimens were evaluated for growth of bacteria on Drigalski's plates, blood agar plates, or chocolate agar plates for 2 days at 37 degrees C. Susceptibilities of the strain to DMPPX, OFLX, minocycline (MINO), gentamicin (GM), erythromycin (EM), cefmenoxime (CMX), chloramphenicol (CP), and sulbenicillin (SBPC) were determined by the disk diffusion method. When DMPPC-resistant Staphylococcus aureus (MRSA) or DMPPC-resistant coagulase- negative staphylococci (MRCNS) were isolated, the susceptibility of the isolated strains to vancomycin (VCM) was additionally examined by the disk diffusion method. Of the 125 preoperative patients (194 eyes), 109 patients (159 eyes) had positive bacterial growth. Methicillin-resistant Staphylococcus aureus (MRSA) were positive in 1 patient. Methicillin-resistant coagulase-negative staphylococci (MRCNS) were positive in another patient. Two eyes with MRSA or MRCNS growth were treated with topical instillation of VCM, which was more sensitive than MINO and GM. They underwent the planned surgery after two subsequent tests showing negative growth. Of 120 isolated coagulase-negative staphylococci (CNS) 8 (6.7%) were resistant to OFLX. OFLX-resistant CNS were sensitive to MINO, CMX, and CP, but also resistant to SBPC. Of 114 isolated aerobic gram-positive rods (GPR), 55 (48.2%) were resistant to OFLX. OFLX-resistant aerobic GPR were sensitive to MINO, CMX, SBPC, and DMPPC. The 157 eyes with positive bacterial growth other than MRSA were treated with topical instillation of sensitive antibiotics. The present findings indicate that DMPPC-resistant staphylococci and OFLX-resistant bacteria exist in conjunctivas without signs of infection.
我们评估了一家眼科诊所术前患者中耐甲氧西林(DMPPC)葡萄球菌和耐氧氟沙星(OFLX)细菌的存在情况。对125例无眼部感染迹象的术前患者的194份结膜标本进行了细菌生长研究。将标本接种于德里加尔斯基平板、血琼脂平板或巧克力琼脂平板上,在37℃下培养2天,观察细菌生长情况。采用纸片扩散法测定菌株对DMPPX、OFLX、米诺环素(MINO)、庆大霉素(GM)、红霉素(EM)、头孢甲肟(CMX)、氯霉素(CP)和磺苄西林(SBPC)的敏感性。当分离出耐DMPPC金黄色葡萄球菌(MRSA)或耐DMPPC凝固酶阴性葡萄球菌(MRCNS)时,采用纸片扩散法进一步检测分离菌株对万古霉素(VCM)的敏感性。在125例术前患者(194只眼)中,109例患者(159只眼)细菌生长呈阳性。1例患者的耐甲氧西林金黄色葡萄球菌(MRSA)呈阳性。另1例患者的耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)呈阳性。对2只生长有MRSA或MRCNS的眼睛进行了VCM局部滴眼治疗,VCM比MINO和GM更敏感。在随后两次检测显示生长阴性后,他们接受了计划中的手术。在120株分离出的凝固酶阴性葡萄球菌(CNS)中,8株(6.7%)对OFLX耐药。耐OFLX的CNS对MINO、CMX和CP敏感,但对SBPC耐药。在114株分离出的需氧革兰氏阳性杆菌(GPR)中,55株(48.2%)对OFLX耐药。耐OFLX的需氧GPR对MINO、CMX、SBPC和DMPPC敏感。对157只除MRSA外细菌生长呈阳性的眼睛进行了敏感抗生素局部滴眼治疗。目前的研究结果表明,在无感染迹象的结膜中存在耐DMPPC葡萄球菌和耐OFLX细菌。