Jhaveri Microbiology Centre, Hyderabad Eye Research Foundation, India.
Cornea. 2009 Dec;28(10):1100-3. doi: 10.1097/ICO.0b013e3181a1658f.
To study the microbiological profile and outcome of ocular infections caused by Achromobacter xylosoxidans.
Medical and microbiology records of patients with A. xylosoxidans ocular infections managed between May 2007 and December 2007 were reviewed.
The authors identified 10 patients whose eyes were infected by A. xylosoxidans during the study period. Of 10 patients, 8 had microbial keratitis, of whom 6 developed an infection after penetrating keratoplasty. The remaining 2 patients had endophthalmitis. The Gram-stained smear did not reveal any organism in 6 of 10 cases. In the 4 remaining cases, Gram-negative bacilli were reported. Out of 10 isolates, 9 were sensitive to ceftazidime, 7 to amikacin, 5 to ciprofloxacin, and 3 to ofloxacin, gatifloxacin, and chloramphenicol. Only one isolate was sensitive to moxifloxacin. Of the 6 patients with graft infection, 2 patients were lost to follow-up, infection was resolved in 3 patients, and the infection remained active in 1 patient. The two patients with endophthalmitis responded to antibacterial therapy and showed improved visual acuity. Infection was resolved in 2 patients with keratitis.
Although A. xylosoxidans ocular infections are rare, one should retain a high index of clinical suspicion in patients who present with slowly progressive disease characterized by a localized infiltration and show Gram-negative bacilli on smear examination.
研究木糖氧化无色杆菌引起的眼部感染的微生物谱和结果。
回顾了 2007 年 5 月至 2007 年 12 月期间患有木糖氧化无色杆菌眼部感染的患者的医学和微生物记录。
在研究期间,作者发现了 10 名眼部感染木糖氧化无色杆菌的患者。10 名患者中有 8 名患有微生物性角膜炎,其中 6 名在穿透性角膜移植术后发生感染。其余 2 名患有眼内炎。在 10 例中有 6 例革兰氏染色涂片未发现任何病原体。在其余 4 例中,报告了革兰氏阴性杆菌。在 10 个分离株中,9 个对头孢他啶敏感,7 个对阿米卡星敏感,5 个对环丙沙星敏感,3 个对氧氟沙星、加替沙星和氯霉素敏感。只有 1 个分离株对莫西沙星敏感。在 6 例移植感染患者中,2 例失访,3 例感染得到解决,1 例感染仍活跃。2 例眼内炎患者对抗菌治疗有反应,视力有所提高。2 例角膜炎患者感染得到解决。
虽然木糖氧化无色杆菌眼部感染很少见,但对于出现进展缓慢的疾病的患者,尤其是表现为局灶性浸润和涂片检查发现革兰氏阴性杆菌的患者,应保持高度的临床怀疑。