Melo Gustavo Barreto, Bispo Paulo José Martins, Regatieri Caio Vinícius Saito, Yu Maria Cecília Zorat, Pignatari Antônio Carlos Campos, Höfling-Lima Ana Luisa
Department of Ophthalmology, Universidade Federal de São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2010 Nov-Dec;73(6):505-7. doi: 10.1590/s0004-27492010000600007.
To report on the incidence, diagnostic technique, and microbiological features of endophthalmitis at a university-setting in Brazil.
All cases of presumed postoperative endophthalmitis from 2002 to 2008 at a teaching-hospital were included. Main data assessed were: number of cataract surgeries performed, incidence of endophthalmitis, microbiological outcome (aqueous and/or vitreous culture and Gram staining), and antimicrobial susceptibility testing of the positive cases.
Seventy-three eyes of 73 patients (43 females and 30 males) developed endophthalmitis after 24,590 cataract surgeries. The incidence decreased from 0.49% in 2003 to 0.17% in 2006 and stabilized afterwards. Coagulase negative Staphylococci (CoNS) and Streptococcus viridans (56.5% and 15%, respectively) were the most common bacterial isolates. Culture and Gram stain were negative in 36.9%. CoNS presented susceptibility rates of 80%-sensitivity to oxacillin, 90% to fourth-generation quinolones and 100% to vancomycin.
The rate of endophthalmitis, diagnostic ability of conventional laboratory investigation, microbial isolates and antibiotic susceptibility are in accordance with other findings of the literature. Despite using prophylactic antibiotic drops, it was possible to identify cases that were susceptible to the antibiotics topically applied.
报告巴西一所大学附属医院眼内炎的发病率、诊断技术及微生物学特征。
纳入2002年至2008年某教学医院所有疑似术后眼内炎病例。评估的主要数据包括：白内障手术例数、眼内炎发病率、微生物学结果（房水和/或玻璃体培养及革兰氏染色）以及阳性病例的抗菌药敏试验。
在24,590例白内障手术后，73例患者（43例女性和30例男性）的73只眼发生了眼内炎。发病率从2003年的0.49%降至2006年的0.17%，此后趋于稳定。凝固酶阴性葡萄球菌（CoNS）和草绿色链球菌（分别为56.5%和15%）是最常见的细菌分离株。36.9%的病例培养及革兰氏染色结果为阴性。CoNS对苯唑西林的敏感率为80%，对第四代喹诺酮类药物的敏感率为90%，对万古霉素的敏感率为100%。
眼内炎发生率、传统实验室检查的诊断能力、微生物分离株及抗生素敏感性与文献中的其他研究结果一致。尽管使用了预防性抗生素滴眼液，但仍可识别出对局部应用抗生素敏感的病例。
