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[富山大学医院过去六年眼部细菌感染的趋势调查——从实验室检查的角度]

[Trend survey of ocular infections with bacteria at Toyama University Hospital over the past six years--from the standpoint of laboratory examination].

作者信息

Kubota Tomomi, Hayashi Shirou, Niimi Hideki, Kitajima Isao

出版信息

Rinsho Byori. 2012 Jul;60(7):605-11.

Abstract

Specimens of bacterial ocular infections are frequently received in the clinical laboratory. However, a comprehensive trend survey of ocular infections with bacteria is very rare. Our objective is to understand the current tendency of ocular infections with bacteria in patients at Toyama University Hospital from the standpoint of laboratory examination. We studied 263 cases of ocular infection with bacteria diagnosed at Toyama University Hospital from January 2006 to December 2011. 123 were male and 140 were female, with a mean age of 61.2(0-98) years. Specimens were subjected to direct microscopy and culture. Cultures were positive in 174(66.2%) patients. The most common bacterial isolate was Staphylococcus (28.1%), followed by Corynebacterium (19.3%), Streptococcus (9.3%), and Propionibacterium (8.6%). MRSA accounted for 18.8% of all S. aureus isolates, and has increased in recent years. The number of bacteria detected was larger in March, June, July, August, and October. Age distribution indicated that around 70% of bacterial isolates were detected from patients over 60 years old. The most common specimen of ocular infections with bacteria was eye discharge (detection rate; 87.8%), followed by corneal scraping(41%), aqueous humor (19%), and vitreous body (27%). Nearly 80% of bacterial isolates were detected from patients with keratitis, endophthalmitis, dacryocystitis, and conjunctivitis. As for the disease specific detection rate, endophthalmitis was very low (38.3%). The detection rate by years indicated that the way doctors pick up the specimens greatly affects the detection rate. Based on this survey, we need close cooperation with medical doctors concerning laboratory examination in ocular infection with bacteria, and we must improve the detection sensitivity of specimens from patients with endophthalmitis.

摘要

临床实验室经常收到细菌性眼部感染的标本。然而,对细菌性眼部感染进行全面的趋势调查却非常罕见。我们的目的是从实验室检查的角度了解富山大学医院患者细菌性眼部感染的当前趋势。我们研究了2006年1月至2011年12月在富山大学医院诊断的263例细菌性眼部感染病例。其中男性123例,女性140例,平均年龄61.2(0 - 98)岁。标本进行了直接显微镜检查和培养。174例(66.2%)患者培养结果呈阳性。最常见的分离细菌是葡萄球菌(28.1%),其次是棒状杆菌(19.3%)、链球菌(9.3%)和丙酸杆菌(8.6%)。耐甲氧西林金黄色葡萄球菌(MRSA)占所有金黄色葡萄球菌分离株的18.8%,且近年来有所增加。3月、6月、7月、8月和10月检测到的细菌数量较多。年龄分布表明,约70%的细菌分离株来自60岁以上的患者。细菌性眼部感染最常见的标本是眼分泌物(检出率;87.8%),其次是角膜刮片(41%)、房水(19%)和玻璃体(27%)。近80%的细菌分离株来自角膜炎、眼内炎、泪囊炎和结膜炎患者。至于疾病特异性检出率,眼内炎非常低(38.3%)。逐年的检出率表明医生采集标本的方式对检出率有很大影响。基于这项调查,我们在细菌性眼部感染的实验室检查方面需要与医生密切合作,并且必须提高眼内炎患者标本的检测灵敏度。

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