Centre for Excellence in Glaucoma, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, South India.
Eye (Lond). 2009 Apr;23(4):945-56. doi: 10.1038/eye.2008.197. Epub 2008 Jul 4.
To identify the microbial aetiology of infectious endophthalmitis and to determine the in vitro antibacterial susceptibilities of bacterial isolates.
A retrospective analysis was carried out of all patients presenting between January 1997 and December 2006 with clinically diagnosed infectious endophthalmitis who underwent microbiological evaluation. Intraocular specimens (aqueous and vitreous fluids) were collected from all cases of clinically suspected infectious endophthalmitis. In addition to intraocular aspirates, blood specimens from endogenous endophthalmitis, and corneal and scleral scrapes from relevant cases were also collected. The collected intraocular specimens, blood specimens, and corneal and scleral scrapes were subjected to microbiological evaluation.
Samples from 955 patients with endophthalmitis underwent microbiological analysis, of which 424 (44.4%) were found to be culture positive. Of 424, 364 (85.8%) had bacterial growth and the remaining 60 (14.2%) had fungal growth. Among post-surgical endophthalmitis, Gram-negative bacilli (75%) were found to be the predominant cause for developing fulminant onset, Staphylococcus spp. (68.6%) for acute, and Streptococcus spp. (75%) for chronic onset of infections, whereas in post-traumatic endophthalmitis, Gram-negative bacilli (65.2%) were found to be the predominant cause for fulminant onset, Gram-positive bacillus (28.4%) for acute onset, and fungi (52.3%) for chronic onset of infections. Endophthalmitis associated with microbial keratitis was mainly caused by filamentous fungi (37.2%) and Gram-negative bacilli (37.2%). Overall, gatifloxacin (97.7%) showed highest activity against bacterial isolates followed by ciprofloxacin (95.9%) and ofloxacin (95.1%).
Gram-negative bacilli cause predominantly fulminant onset, Staphylococci and Gram-positive bacilli acute, and Streptococci, Nocardia, and fungi chronic endophthalmitis. Gatifloxacin demonstrated greatest efficacy against these bacterial isolates.
确定感染性眼内炎的微生物病因，并确定细菌分离株的体外抗菌药敏率。
对 1997 年 1 月至 2006 年 12 月间所有经临床诊断为感染性眼内炎且接受微生物评估的患者进行回顾性分析。对所有疑似感染性眼内炎的临床病例均采集眼内标本（房水和玻璃体液）。除眼内抽吸物外，还采集内源性眼内炎的血标本以及相关病例的角膜和巩膜刮片。对采集的眼内标本、血标本和角膜及巩膜刮片进行微生物评估。
对 955 例眼内炎患者的样本进行了微生物分析，其中 424 例（44.4%）培养阳性。在 424 例培养阳性的患者中，364 例（85.8%）有细菌生长，其余 60 例（14.2%）有真菌生长。在手术后眼内炎中，革兰氏阴性杆菌（75%）是导致暴发性发病的主要原因，葡萄球菌属（68.6%）是急性发病的主要原因，链球菌属（75%）是慢性发病的主要原因，而在创伤后眼内炎中，革兰氏阴性杆菌（65.2%）是导致暴发性发病的主要原因，革兰氏阳性杆菌（28.4%）是急性发病的主要原因，真菌（52.3%）是慢性发病的主要原因。与微生物角膜炎相关的眼内炎主要由丝状真菌（37.2%）和革兰氏阴性杆菌（37.2%）引起。总体而言，加替沙星（97.7%）对细菌分离株的活性最高，其次是环丙沙星（95.9%）和左氧氟沙星（95.1%）。
革兰氏阴性杆菌主要引起暴发性发病，葡萄球菌属和革兰氏阳性杆菌引起急性发病，链球菌属、诺卡菌属和真菌引起慢性发病。加替沙星对这些细菌分离株显示出最大的疗效。
