Huang Yu-sen, Dai Yun-hai, Sun Shi-ying, Lan Jie, Xie Li-xin
Qingdao Eye Hospital, Shandong Eye Institute, Qingdao, China.
Zhonghua Yi Xue Za Zhi. 2009 Sep 22;89(35):2458-61.
To study the conjunctival bacteria flora in eyes of patients undergoing cataract surgery and determine the efficacy of reducing conjunctival bacteria with different methods.
A total of 135 eyes of 135 patients scheduled to undergo cataract surgery were randomized into 3 groups (45 each). They received topical prophylactic treatment with three different kinds of antibiotics (0.5% levofloxacin, 0.3% levofloxacin and 0.3% tobramycin). Each group was randomized into one-day group and three-day group. All the eyes underwent irrigation of fornices with 2.5% povidone-iodine (PVI) before surgery. Conjunctival cultures were obtained at various time points.
The total positive rate of conjunctival cultures was 66.7%. The eliminating rate of conjunctival bacteria in one-day groups were 72.7%, 72.7% and 61.1% (P = 0.667) while 70.0%, 70.0% and 55.5% in the three-day groups respectively (P = 0.751). Immediately after PVI irrigation, the eliminating rate in one-day groups added up to 86.4%, 77.3% and 88.9% (P = 0.564) as compared with 90.0%, 80.0% and 66.7% in the three-day groups respectively (P = 0.749). And there was no statistically significant difference between one-day groups and three-day groups in the eliminating rate of conjunctival bacterial after the topical antibiotic application. The MIC test revealed that the antibiotic sensitivity of Gram-positive cocci (G(+)C) to levofloxacin was 94.8% versus 74.1% to tobramycin (P = 0.000) while the antibiotic sensitivity of Gram-negative bacillus (G(-)B) to levofloxacin was 94.4% versus 83.3% to tobramycin (P = 0.289).
G(+)C accounts for the most among the conjunctival bacteria flora in eyes of patients undergoing cataract surgery and there is no statistically significant difference in the efficacy of reducing conjunctival bacteria between the application of topical antibiotic for one day and for three days. Both G(+)C and G(-)B retain a high sensitivity to levofloxacin. Topical antibiotic in combination with 2.5% PVI irrigation further reduces conjunctival bacteria.
研究白内障手术患者眼部结膜细菌菌群，并确定不同方法减少结膜细菌的效果。
将135例计划行白内障手术患者的135只眼随机分为3组（每组45只眼）。分别接受三种不同抗生素（0.5%左氧氟沙星、0.3%左氧氟沙星和0.3%妥布霉素）的局部预防性治疗。每组再随机分为一日组和三日组。所有术眼术前均用2.5%聚维酮碘（PVI）冲洗结膜囊。在不同时间点采集结膜培养物。
结膜培养物总阳性率为66.7%。一日组结膜细菌清除率分别为72.7%、72.7%和61.1%（P = 0.667），三日组分别为70.0%、70.0%和55.5%（P = 0.751）。PVI冲洗后即刻，一日组清除率分别为86.4%、77.3%和88.9%（P = 0.564），三日组分别为90.0%、80.0%和66.7%（P = 0.749）。局部应用抗生素后，一日组和三日组结膜细菌清除率无统计学差异。MIC试验显示，革兰阳性球菌（G(+)C）对左氧氟沙星的抗生素敏感性为94.8%，对妥布霉素为74.1%（P = 0.000）；革兰阴性杆菌（G(-)B）对左氧氟沙星的抗生素敏感性为94.4%，对妥布霉素为83.3%（P = 0.289）。
白内障手术患者眼部结膜细菌菌群中G(+)C占比最高，局部应用抗生素一日与三日减少结膜细菌的效果无统计学差异。G(+)C和G(-)B对左氧氟沙星均保持高敏感性。局部应用抗生素联合2.5%PVI冲洗可进一步减少结膜细菌。
