在印度南部的一家三级眼科医院中，社区获得性细菌性眼部感染的病因和抗菌药物敏感性模式。
Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India.
机构信息
Department of Microbiology, Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
出版信息
Indian J Ophthalmol. 2010 Nov-Dec;58(6):497-507. doi: 10.4103/0301-4738.71678.
AIMS
To identify the etiology, incidence and prevalence of ocular bacterial infections, and to assess the in vitro susceptibility of these ocular bacterial isolates to commonly used antibiotics.
MATERIALS AND METHODS
Retrospective analysis of consecutive samples submitted for microbiological evaluation from patients who were clinically diagnosed with ocular infections and were treated at a tertiary eye care referral center in South India between January 2002 and December 2007.
RESULTS
A total of 4417 ocular samples was submitted for microbiological evaluation, of which 2599 (58.8%) had bacterial growth, 456 (10.3%) had fungal growth, 15 (0.34%) had acanthamoebic growth, 14 (0.32%) had mixed microbial growth and the remaining 1333 (30.2%) had negative growth. The rate of culture-positivity was found to be 88% (P < 0.001) in eyelids' infection, 70% in conjunctival, 69% in lacrimal apparatus, 67.4% in corneal, 51.6% in intraocular tissues, 42.9% in orbital and 39.2% in scleral infections. The most common bacterial species isolated were Staphylococcus aureus (26.69%) followed by Streptococcus pneumoniae (22.14%). Sta. aureus was more prevalent more in eyelid infections (51.22%; P = 0.001) coagulase-negative staphylococci in endophthalmitis (53.1%; P = 0.001), Str. pneumoniae in lacrimal apparatus and corneal infections (64.19%; P = 0.001), Corynebacterium species in blepharitis and conjunctivitis (71%; P = 0.001), Pseudomonas aeruginosa in keratitis and dacryocystitis (66.5%; P = 0.001), Haemophilus species in dacryocystitis and conjunctivitis (66.7%; P = 0.001), Moraxella lacunata in blepharitis (54.17%; P = 0.001) and Moraxella catarrhalis in dacryocystitis (63.83%; P = 0.001). The largest number of gram-positive isolates was susceptible to moxifloxacin (98.7%) and vancomycin (97.9%), and gram-negative isolates to amikacin (93.5%) and gatifloxacin (92.7%).
CONCLUSIONS
Gram-positive cocci were the most frequent bacteria isolated from ocular infections and were sensitive to moxifloxacin and vancomycin, while gram-negative isolates were more sensitive to amikacin and gatifloxacin.
目的
确定眼部细菌性感染的病因、发病率和患病率，并评估这些眼部细菌分离株对常用抗生素的体外敏感性。
材料和方法
对 2002 年 1 月至 2007 年 12 月在印度南部一家三级眼科转诊中心就诊的临床诊断为眼部感染的患者连续送检的微生物评估标本进行回顾性分析。
结果
共送检 4417 份眼部标本进行微生物评估，其中 2599 份（58.8%）有细菌生长，456 份（10.3%）有真菌生长，15 份（0.34%）有棘阿米巴生长，14 份（0.32%）有混合微生物生长，其余 1333 份（30.2%）生长阴性。结果发现，眼睑感染的培养阳性率为 88%（P < 0.001），结膜为 70%，泪器为 69%，角膜为 67.4%，眼内组织为 51.6%，眼眶为 42.9%，巩膜为 39.2%。分离出的最常见细菌种类为金黄色葡萄球菌（26.69%），其次为肺炎链球菌（22.14%）。金黄色葡萄球菌在眼睑感染中更为常见（51.22%；P = 0.001），凝固酶阴性葡萄球菌在眼内炎中更为常见（53.1%；P = 0.001），肺炎链球菌在泪器和角膜感染中更为常见（64.19%；P = 0.001），棒状杆菌属在睑缘炎和结膜炎中更为常见（71%；P = 0.001），铜绿假单胞菌在角膜炎和泪囊炎中更为常见（66.5%；P = 0.001），嗜血杆菌属在泪囊炎和结膜炎中更为常见（66.7%；P = 0.001），莫拉菌属在睑缘炎中更为常见（54.17%；P = 0.001），卡他莫拉菌在泪囊炎中更为常见（63.83%；P = 0.001）。革兰氏阳性球菌对莫西沙星（98.7%）和万古霉素（97.9%）的敏感性最高，革兰氏阴性菌对阿米卡星（93.5%）和加替沙星（92.7%）的敏感性最高。
结论
革兰氏阳性球菌是眼部感染最常见的细菌，对莫西沙星和万古霉素敏感，而革兰氏阴性菌对阿米卡星和加替沙星更敏感。
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