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[针对眼部感染分离出的微生物对抗菌药物敏感性的八年回顾]

[An eight-year review of sensitivity to antimicrobials against isolated microorganisms from ocular infections].

作者信息

Hori Yukiko, Mochizuki Kiyofumi, Murase Hiroki, Suematsu Hiroyuki, Yamagishi Yuka, Mikamo Hiroshige

机构信息

Department of Ophthalmology, JA Gifu Koseiren Chuno General Hospital, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 2009 May;113(5):583-95.

Abstract

OBJECTIVE

To obtain data beneficial for future treatment by observing the circumstances relating to microorganisms isolated in external ocular infections and drug sensitivity, along with changes in drug-resistant bacteria.

SUBJECTS AND METHODS

For an eight-year period from April 1998 to March 2006, the cultivation and identification of secretions from conjunctival sac and drug sensitivity tests were conducted at JA Gifu Koseiren Chuno General Hospital involving 3,876 patients (1,809 males and 2,067 females; average age: 44.2 +/- 29.3 years old, ranging from 0-99 years old) diagnosed with external ocular infections by the Department of Ophthalmology. Sensitivity test results were evaluated based on the US CLSI standards.

RESULTS

Of the 5,002 samples, 3,447 tested positive for cultures (isolation rate: 68.9%). A total of 4,537 strains were isolated. In descending order, the microorganisms isolated were 1,706 strains of coagulase negative Staphylococcus (CNS), including Staphylococcus epidermidis (37.6%), 936 strains of Corynebacterium spp. (20.6%), 635 strains of Staphylococcus aureus (14.0%), 412 strains of Haemophilus influenzae (9.1%), and 246 strains of Streptococcus pneumoniae (5.4%). CNS, Corynebacterium and S. aureus were isolated in relatively large numbers in patients of all ages. H. influenzae and S. pneumoniae were common in children six and under and from winter to spring. At the sametime, resistant bacteria (PRSP or PISP: 166 strains; 2000 onward, BLNAR: 192 strains; and BLPACR: 6 strains) were detected more frequently than sensitive bacteria. H. influenzae was hypersensitive to cefotaxime (CTX) and levofloxacin. Almost no toleration of CTX was observed in S. pneumoniae.

DISCUSSION AND CONCLUSION

There are distinctions in the isolated bacteria according to age and season, and the use of drugs that are appropriate to the antibiograms of each facility should be considered.

摘要

目的

通过观察眼外感染中分离出的微生物情况、药敏情况以及耐药菌的变化,获取对未来治疗有益的数据。

对象与方法

在1998年4月至2006年3月的八年期间,岐阜县农业协同组合共济中野综合医院眼科对3876例(男性1809例,女性2067例;平均年龄:44.2±29.3岁,年龄范围0 - 99岁)被诊断为眼外感染的患者进行结膜囊分泌物培养、鉴定及药敏试验。药敏试验结果依据美国临床和实验室标准协会(CLSI)标准进行评估。

结果

在5002份样本中,3447份培养呈阳性(分离率:68.9%)。共分离出4537株菌株。分离出的微生物按数量由多到少依次为:凝固酶阴性葡萄球菌(CNS)1706株,其中表皮葡萄球菌占37.6%;棒状杆菌属936株(20.6%);金黄色葡萄球菌635株(14.0%);流感嗜血杆菌412株(9.1%);肺炎链球菌246株(5.4%)。各年龄段患者中,CNS、棒状杆菌属和金黄色葡萄球菌的分离数量相对较多。流感嗜血杆菌和肺炎链球菌在6岁及以下儿童以及冬季至春季较为常见。同时,耐药菌(PRSP或PISP:166株;2000年起,BLNAR:192株;BLPACR:6株)的检出频率高于敏感菌。流感嗜血杆菌对头孢噻肟(CTX)和左氧氟沙星高度敏感。肺炎链球菌对CTX几乎无耐受性。

讨论与结论

分离出的细菌存在年龄和季节差异,应考虑使用适合各机构抗菌谱的药物。

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