Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 N.W. 17th Street, Miami, FL 33136, USA.
Clin Exp Ophthalmol. 2012 Jul;40(5):467-75. doi: 10.1111/j.1442-9071.2011.02679.x. Epub 2011 Nov 4.
To provide an update on the frequency, distribution, risk factors and in vitro susceptibility of ocular infections caused by non-tuberculous mycobacteria.
Retrospective study of university clinic patients.
One hundred thirty-nine patients with culture confirmed non-tuberculous mycobacteria infections seen at Bascom Palmer Eye Institute from January 1980 to July 2007.
Chart review of data collected included patients' demographics, risk factors, microbiological profiles and clinical outcomes.
Frequency, distribution, risk factors and in vitro susceptibility of ocular infections caused by non-tuberculous mycobacteria.
A total of 183 non-tuberculous mycobacteria isolates from 142 eyes were identified, with a fourfold increase in the number of eyes infected with non-tuberculous mycobacteria from 1980-1989 (13.4%) to 2000-2007 (56.3%). Eighty-three percent of non-tuberculous mycobacteria isolates were identified as M. abscessus/chelonae. The majority (91%) of isolates were recovered within 10 days. Common diagnoses included keratitis (36.6%), scleral buckle infections (14.8%) and socket/implant infections (14.8%). Identifiable risk factors were presence of biomaterials (63.1%), ocular surgery (24.1%) and steroid exposure (77%). The median time from diagnosis of culture positive non-tuberculous mycobacteria infection to resolution was 13 to 24 weeks. Combination therapy was used to treat 80% of infected eyes. In vitro susceptibility of non-tuberculous mycobacteria isolates were: amikacin, 81%; clarithromycin, 93%; and moxifloxacin, 21%.
The incidence of ocular infections caused by non-tuberculous mycobacteria has increased within the last 8 years, with a high number of biomaterial associated infections among this group. Clinical diagnosis and microbiological confirmation of non-tuberculous mycobacteria infections remains challenging. Patient outcomes may be improved by early diagnosis, appropriate therapy and removal of biomaterials.
提供非结核分枝杆菌引起的眼部感染的频率、分布、危险因素和体外药敏更新。
对巴斯科姆帕尔默眼科研究所从 1980 年 1 月至 2007 年 7 月期间就诊的确诊为非结核分枝杆菌感染的患者进行回顾性研究。
139 例经培养证实为非结核分枝杆菌感染的患者。
对收集的图表资料进行了回顾，包括患者的人口统计学资料、危险因素、微生物学特征和临床结局。
非结核分枝杆菌引起的眼部感染的频率、分布、危险因素和体外药敏。
共从 142 只眼中分离出 183 株非结核分枝杆菌，1980-1989 年（13.4%）感染非结核分枝杆菌的眼数增加了 4 倍，2000-2007 年（56.3%）感染非结核分枝杆菌的眼数增加了 4 倍。83%的非结核分枝杆菌分离株被鉴定为 M. abscessus/chelonae。大多数（91%）分离株在 10 天内被分离出来。常见的诊断包括角膜炎（36.6%）、巩膜扣带感染（14.8%）和眼眶/植入物感染（14.8%）。可识别的危险因素是存在生物材料（63.1%）、眼外科手术（24.1%）和皮质类固醇暴露（77%）。从培养阳性非结核分枝杆菌感染诊断到治愈的中位时间为 13-24 周。80%的感染眼采用联合治疗。非结核分枝杆菌分离株的体外药敏试验结果为：阿米卡星，81%；克拉霉素，93%；莫西沙星，21%。
过去 8 年来，非结核分枝杆菌引起的眼部感染发病率有所增加，其中有大量与生物材料相关的感染。非结核分枝杆菌感染的临床诊断和微生物学确认仍然具有挑战性。早期诊断、适当的治疗和生物材料的去除可能会改善患者的预后。
