由于耐甲氧西林金黄色葡萄球菌对第四代氟喹诺酮类耐药导致的扁平部玻璃体切除术后感染性巩膜炎。
Infectious scleritis after pars plana vitrectomy because of methicillin-resistant Staphylococcus aureus resistant to fourth-generation fluoroquinolones.
作者信息
Feiz Vahid, Redline Daniel E
机构信息
Department of Ophthalmology and Vision Science, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
出版信息
Cornea. 2007 Feb;26(2):238-40. doi: 10.1097/01.ico.0000248383.09272.ee.
PURPOSE
To describe a case of infectious scleritis caused by methicillin-resistant Staphylococcus aureus (MRSA) after pars plana vitrectomy despite treatment with topical fourth-generation fluoroquinolones.
METHODS
Single interventional case report.
RESULTS
A 72-year-old man presented with scleral thinning and subconjunctival abscess 1 month after pars plana vitrectomy. Microbiological studies including cultures and antibiotic sensitivity were performed. Culture of the scleral abscess showed growth of MRSA resistant to fourth-generation fluoroquinolones and sensitive to vancomycin and erythromycin. Treatment with a combination of topical vancomycin and systemic erythromycin for 6 weeks resolved the infectious scleritis.
CONCLUSIONS
MRSA can be a cause of infectious scleritis after ocular surgery without a clear source despite surgical prophylaxis with topical fourth-generation fluoroquinolones.
目的
描述一例尽管使用了局部四代氟喹诺酮类药物治疗，但在玻璃体切割术后仍由耐甲氧西林金黄色葡萄球菌（MRSA）引起感染性巩膜炎的病例。
方法
单例干预病例报告。
结果
一名72岁男性在玻璃体切割术后1个月出现巩膜变薄和结膜下脓肿。进行了包括培养和抗生素敏感性在内的微生物学研究。巩膜脓肿培养显示出对四代氟喹诺酮类耐药但对万古霉素和红霉素敏感的MRSA生长。局部使用万古霉素和全身使用红霉素联合治疗6周后，感染性巩膜炎得到缓解。
结论
尽管术前使用局部四代氟喹诺酮类药物进行了预防，但MRSA仍可能是眼部手术后感染性巩膜炎的病因，且感染源不明。
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