德黑兰一家转诊中心收治的经培养证实的眼内炎病例的分离菌株及抗生素耐药性
Isolates and antibiotic resistance of culture-proven endophthalmitis cases presented to a referral center in Tehran.
作者信息
Falavarjani Khalil Ghasemi, Nekoozadeh Shahbaz, Modarres Mehdi, Parvaresh Mohammad M, Hashemi Masih, Soodi Reza, Alemzadeh Sayyed Amirpooya
机构信息
Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Middle East Afr J Ophthalmol. 2012 Oct;19(4):361-3. doi: 10.4103/0974-9233.102740.
PURPOSE
To evaluate the spectrum of organisms causing endophthalmitis and their resistance pattern to standard antimicrobial agents.
MATERIALS AND METHODS
Medical records of culture positive eyes treated at Rassoul Akram Hospital for endophthalmitis during the past 5 years were reviewed. Specimens were obtained during pars plana vitrectomy or vitreous tap.
RESULTS
Sixty-five isolates including 36 (55.4%) gram-positive organisms, 28 gram-negative organisms (43.1%), and 1 (1.5%) fungus were studied. The most common organism identified was Coagulase-negative staphylococcus in 16 eyes (24.6%). Among the antibiotics available for intravitreal injection, the least antibiotic resistance was for vancomycin in gram-positive organisms and amikacin and ceftazidime in gram-negative isolates.
CONCLUSIONS
Gram-positive isolates were the most prevalent organisms; however, a high isolation rate for gram-negative organisms was obtained. Considering that no single antibiotic provides coverage for all of the organisms, a combination therapy using vancomycin/amikacin or vancomycin/ceftazidime seems to be useful as the initial empiric treatment of suspected bacterial endophthalmitis.
目的
评估引起眼内炎的微生物谱及其对标准抗菌药物的耐药模式。
材料与方法
回顾了拉苏勒·阿克拉姆医院过去5年治疗的培养阳性眼内炎患者的病历。标本在玻璃体切割术或玻璃体穿刺时获取。
结果
共研究了65株分离菌，其中革兰氏阳性菌36株（55.4%），革兰氏阴性菌28株（43.1%），真菌1株（1.5%）。最常见的分离菌是凝固酶阴性葡萄球菌，见于16只眼（24.6%）。在可用于玻璃体内注射的抗生素中，革兰氏阳性菌对万古霉素的耐药性最低，革兰氏阴性菌对阿米卡星和头孢他啶的耐药性最低。
结论
革兰氏阳性分离菌是最常见的微生物；然而，革兰氏阴性菌的分离率也很高。鉴于没有单一抗生素能覆盖所有微生物，使用万古霉素/阿米卡星或万古霉素/头孢他啶的联合疗法似乎可作为疑似细菌性眼内炎的初始经验性治疗方法。
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