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[白内障手术患者的结膜细菌:过去50年的变化]

[Conjunctival bacteria of patients undergoing cataract surgery: changes in the last 50 years].

作者信息

Fernández Rubio E

机构信息

Laboratorio de Análisis Clínicos del Instituto Oftálmico, Departamento de Oftalmología, Hospital General Universitario Gregorio Marañón, Madrid, España.

出版信息

Arch Soc Esp Oftalmol. 2004 Jan;79(1):13-9. doi: 10.4321/s0365-66912004000100005.

Abstract

PURPOSE

To describe the prevalence of preoperative conjunctival bacteria of patients living in Madrid, who underwent cataract surgery in our hospital, without using exclusion criteria to select the patients.

METHOD

The preoperative conjunctival cultures of 4432 consecutive patients, in a three year period, were studied retrospectively. Samples of preoperative conjunctival cultures were selected from publications of the past 50 years. Our conjunctival bacteria frequencies were compared with those of other samples (chi-square test), in order to show that the bacterial isolation method is a determinant factor of the bacterial spectrum.

RESULTS

93.5% bacteria were Gram positive and 6.5% Gram negative. Each bacteria group was present in the patients as follows: 56.9% Staphylococcus coagulase negative, 30.5% Corynebacterium sp, 6.5% Staphylococcus Aureus, 2.7% Streptococcus Pneumoniae, 5.6% other Streptococcus sp, 2.8% Haemophilus sp, 3.5% other Gram negative rods, 1.2% diplococci Gram negative and 0.5% other bacteria. Pathogen bacteria were isolated in 19.1% of the patients and 21.9% of the cultures were negative. The samples shown in publications previous to 1980 (table II), present bacteria frequencies statistically different from our study.

CONCLUSIONS

The conjunctival bacteria prevalence in preoperative cultures of patients awaiting cataract surgery had never been described in Madrid. By analysing other authors' results, it can be seen that bacteria prevalence is affected by the culture media used. It also seems that the size of the sample and the health status of the patients could affect this prevalence (Arch Soc Esp Oftalmol 2004; 79: 13-20).

摘要

目的

描述我院接受白内障手术的马德里患者术前结膜细菌的流行情况,不采用排除标准来选择患者。

方法

回顾性研究连续4432例患者在三年期间的术前结膜培养情况。术前结膜培养样本选自过去50年的出版物。将我们的结膜细菌频率与其他样本的频率进行比较(卡方检验),以表明细菌分离方法是细菌谱的决定因素。

结果

93.5%的细菌为革兰氏阳性菌,6.5%为革兰氏阴性菌。各细菌组在患者中的占比情况如下:凝固酶阴性葡萄球菌56.9%,棒状杆菌属30.5%,金黄色葡萄球菌6.5%,肺炎链球菌2.7%,其他链球菌属5.6%,嗜血杆菌属2.8%,其他革兰氏阴性杆菌3.5%,革兰氏阴性双球菌1.2%,其他细菌0.5%。19.1%的患者分离出病原菌,21.9%的培养结果为阴性。1980年以前出版物中所示的样本(表II),其细菌频率与我们的研究在统计学上存在差异。

结论

马德里此前从未描述过等待白内障手术患者术前培养中的结膜细菌流行情况。通过分析其他作者的结果可以看出,细菌流行情况受所用培养基的影响。样本大小和患者健康状况似乎也会影响这种流行情况(《西班牙眼科协会杂志》2004年;79:13 - 20)。

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