Gerkowicz Marek, Gruszecka-Gerkowicz Renata, Kosior-Jarecka Ewa, Pietraś-Trzpiel Małgorzata
Z II Kliniki Okulistyki Akademii Medycznej w Lublinie.
Klin Oczna. 2005;107(10-12):675-80.
The aim of the study was to estimate changes in bacterial flora of conjunctival sac changes in patients prophylacticaly treated with different antibiotics (chloramphenicol, gentamycin, ofloxacin, norfloxacin) before cataract operation.
The studied group consisted of 166 patients hospitalized for cataract surgery. The control group consisted of 33 persons, neither treated topically with antimicrobial drugs nor suffering from infectious or inflammatory diseases. On the first day and on the operation day conjunctival swabs were obtained and typical microbiological diagnosis was performed. During hospitalization only one antimicrobial drug was administrated topically (chloramphenicol, gentamycin, ofloxacin or norfloxacin) in the studied group.
Prophylaxis with antibiotics before cataract surgery changes bacterial flora of conjunctival sac: quantitative changes were observed most frequently, but also hospital antibiotic resistant strains were detected. None of tested antibiotics caused total elimination of conjunctival flora in all patients.
None of the antibiotics used in our study could cause total elimination of conjunctival flora. According to our results, the most effective antibiotics in prophylaxis before eye surgery are fluoroquinolones. Some patients before eye surgery have the pathogenetic conjunctival flora not causing the disease, yet increasing the risk of postoperative endophthalmitis.
本研究旨在评估白内障手术前预防性使用不同抗生素（氯霉素、庆大霉素、氧氟沙星、诺氟沙星）的患者结膜囊细菌菌群的变化。
研究组由166例因白内障手术住院的患者组成。对照组由33人组成，既未局部使用抗菌药物，也未患有感染性或炎症性疾病。在第一天和手术当天采集结膜拭子并进行典型的微生物学诊断。研究组在住院期间仅局部使用一种抗菌药物（氯霉素、庆大霉素、氧氟沙星或诺氟沙星）。
白内障手术前使用抗生素进行预防会改变结膜囊的细菌菌群：最常观察到数量变化，但也检测到医院内的抗生素耐药菌株。所测试的抗生素均未导致所有患者的结膜菌群完全消除。
我们研究中使用的抗生素均不能导致结膜菌群完全消除。根据我们的结果，眼科手术前预防最有效的抗生素是氟喹诺酮类。一些眼科手术前的患者具有致病性结膜菌群，但不引起疾病，却增加了术后眼内炎的风险。
