Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Florida, USA.
Am J Ophthalmol. 2011 Dec;152(6):999-1004.e2. doi: 10.1016/j.ajo.2011.05.026. Epub 2011 Aug 20.
To identify the resistance profiles of conjunctival and nasal bacterial isolates in patients undergoing intravitreal injections and to determine if frequent exposures to topical fluoroquinolones increased antimicrobial resistance among these organisms.
Prospective cohort study.
Patients undergoing intravitreal injection at our institution were enrolled in this study. The conjunctiva and nares of both sides of the patient's face were swabbed and cultured before antiseptic preparation for intravitreal injection. At the time of the study, all patients received 3 days of moxifloxacin eye drops after each intravitreal injection as prophylaxis against endophthalmitis. Resistance to antimicrobials was analyzed using the chi-square test and t test.
Two hundred eight conjunctival and nasal specimens were cultured from 104 patients. Forty-two (45%) of 93 patients had at least 1 fluoroquinolone-resistant organism in the nose or conjunctiva. Twelve (48%) of 25 patients with no previous injections had at least 1 resistant organism; 14 (45%) of 31 patients with 1 to 4 previous injections had at least 1 resistant organism; 8 (33%) of 24 patients with 5 to 9 previous injections had at least 1 resistant organism; and 8 (62%) of 13 patients with 10 or more previous injections had at least 1 resistant organism (P = .88; chi-square test, linear by linear association).
In this small study, there was no correlation between the number of exposures to topical fluoroquinolones and resistance to fluoroquinolones in nasal and conjunctival flora, but there was a high prevalence of fluoroquinolone resistance among all patient groups.
确定接受玻璃体腔内注射的患者的结膜和鼻腔细菌分离株的耐药谱，并确定频繁接触局部氟喹诺酮类药物是否会增加这些生物体的抗菌药物耐药性。
前瞻性队列研究。
本研究纳入了在我院接受玻璃体腔内注射的患者。在进行玻璃体腔内注射的消毒准备之前，对患者面部两侧的结膜和鼻腔进行了拭子和培养。在研究期间，所有患者在每次玻璃体腔内注射后接受 3 天的莫西沙星滴眼液滴眼，以预防眼内炎。使用卡方检验和 t 检验分析抗菌药物的耐药性。
从 104 名患者中培养了 208 个结膜和鼻腔标本。93 名患者中有 42 名（45%）至少在鼻腔或结膜中有 1 种氟喹诺酮类耐药菌。25 名无既往注射史的患者中有 12 名（48%）至少有 1 种耐药菌；31 名有 1 至 4 次既往注射史的患者中有 14 名（45%）至少有 1 种耐药菌；24 名有 5 至 9 次既往注射史的患者中有 8 名（33%）至少有 1 种耐药菌；13 名有 10 次或以上既往注射史的患者中有 8 名（62%）至少有 1 种耐药菌（P=.88；卡方检验，线性关联）。
在这项小型研究中，局部氟喹诺酮类药物暴露次数与鼻腔和结膜菌群对氟喹诺酮类药物的耐药性之间没有相关性，但所有患者群体中氟喹诺酮类药物耐药性的发生率都很高。
