乌干达坎帕拉市穆拉戈国家医院白内障术前患者眼表外细菌分离株及其抗菌药物敏感性模式。
External ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital in Kampala, Uganda.
机构信息
Department of Medical Microbiology, Makerere University College of Health Sciences, P,O, Box 7072, Kampala, Uganda.
出版信息
BMC Ophthalmol. 2013 Nov 15;13:71. doi: 10.1186/1471-2415-13-71.
BACKGROUND
Endophthalmitis is a severe complication of cataract surgery which leads to high ocular morbidity and visual loss even with antibiotic treatment. Bacterial ocular floras are the implicated causative agents. This study was undertaken to evaluate the external ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital.
METHODS
This cross sectional study enrolled consecutively 131 patients scheduled for routine cataract surgery in the Department of Ophthalmology at Mulago National Hospital in Kampala, Uganda. Eyelid margin and conjunctival swabs were collected and processed using standard microbiological procedures to identify bacterial isolates and their respective antimicrobial susceptibility patterns.
RESULTS
Of 131 patients involved (mean age 63.3 ± 14.5 years), 54.2% (71/131) were females. The eyelid margin and conjunctival samples were culture positive in 59.5% (78/138) and 45.8% (60/138) respectively. The most common organisms identified were Coagulase-negative Staphylococci (CoNS) [65.9% (91/138)] and Staphylococcus aureus [21.0% (29/138)]. CoNS showed the highest resistance to tetracycline (58.2%, 53/91) and erythromycin (38.5%, 35/91), whereas in S. aureus the resistance to tetracycline and erythromycin were 55.2% (16/29) and 31.0% (9/29) respectively. Methicillin resistant CoNS (MRS) and Methicillin resistance S. aureus (MRSA) were 31.9% (29/91) and 27.6% (8/29) respectively. There were low resistance rates for CoNS, S. aureus and other bacterial isolates to ciprofloxacin (11.1%-24.2%), gentamicin (5.6-31.0%), tobramycin (17.2% -25.3%) and vancomycin (0.0%).
CONCLUSION
CoNS and S. aureus are the most common bacterial isolates found on the external ocular surface of the pre-operative cataract patients. Ciprofloxacin, gentamicin, tobramycin and vancomycin showed the lowest resistance rates to all bacterial isolates, therefore may be used to reduce bacteria load in the conjunctiva sac among cataract patients prior to surgery.
背景
眼内炎是白内障手术后的一种严重并发症，即使经过抗生素治疗，仍会导致高眼部发病率和视力丧失。细菌眼内菌群是导致这种疾病的原因。本研究旨在评估乌干达坎帕拉穆拉戈国家医院术前白内障患者的眼外部细菌分离株及其对不同抗菌药物的敏感性。
方法
本横断面研究连续纳入了 131 名在乌干达坎帕拉穆拉戈国家医院眼科接受常规白内障手术的患者。使用标准微生物学程序收集并处理眼睑缘和结膜拭子，以鉴定细菌分离株及其各自的抗菌药物敏感性模式。
结果
在纳入的 131 名患者中（平均年龄 63.3±14.5 岁），54.2%（71/131）为女性。59.5%（78/138）和 45.8%（60/138）的眼睑缘和结膜样本分别培养阳性。最常见的分离物为凝固酶阴性葡萄球菌（CoNS）[65.9%（91/138）]和金黄色葡萄球菌[21.0%（29/138）]。CoNS 对四环素（58.2%，53/91）和红霉素（38.5%，35/91）的耐药率最高，而金黄色葡萄球菌对四环素和红霉素的耐药率分别为 55.2%（16/29）和 31.0%（9/29）。耐甲氧西林凝固酶阴性葡萄球菌（MRS）和耐甲氧西林金黄色葡萄球菌（MRSA）的检出率分别为 31.9%（29/91）和 27.6%（8/29）。CoNS、金黄色葡萄球菌和其他细菌分离株对环丙沙星（11.1%-24.2%）、庆大霉素（5.6-31.0%）、妥布霉素（17.2%-25.3%）和万古霉素（0.0%）的耐药率较低。
结论
术前白内障患者的眼外部最常见的细菌分离株是凝固酶阴性葡萄球菌和金黄色葡萄球菌。环丙沙星、庆大霉素、妥布霉素和万古霉素对所有细菌分离株的耐药率最低，因此可用于术前减少白内障患者结膜囊内的细菌负荷。
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