Farhan Essa Abdullah, MBBS, MPhil, PhD (Microbiology), Assistant Professor of Microbiology and Immunology, Dr. Essa's Laboratory & Diagnostic Center, Karachi.
Mariya Irfan Khan, Final Year MBBS, Sindh Medical College, Karachi, Pakistan.
Pak J Med Sci. 2013 Jan;29(1):81-4. doi: 10.12669/pjms.291.2566.
To identify the etiological agent in bacterial conjunctivitis and to determine the antibiogram of bacterial isolates.
This observational study was conducted at Dr. Essa's Laboratory over a period of 12 months ending in March 2012. Two hundred samples taken from conjunctiva of patients with conjunctivitis were cultured on routine medium and the antibiograms of bacterial isolates were determined by Kirby- Bauer disc diffusion method.
The analysis of the culture showed that 41% were cultured positive with gram positive bacteria Staphylococcus aureus 52.5% and Staphylococcus epidermidis 30.1% and Micrococci 8.3%. However, 9.1% were gram negatives with Klebsiella pneumoniae 5.14% and Pseudomonas aeruginosa 2.6% and 1.36% were others (Acinetobacter, Haemophilus , E.coli and Moraxella) keeping in view the increasing use of contact lens and unclean fingers. The overall antibiograms of bacterial isolates indicate aminoglycosides (gentamicin, tobramicin) and the newer quinolones as apparent drug of choice for empirical therapy, followed by chloramphenicol, since drug fussy gram-negatives such as Pseudomonas, Acinetobacter and E.coli were among the conjunctival isolates. Resistance profile of gram positive isolates shows cefixime 91.4%, doxycycline 57.9%, cotrimoxazole 29.3%, ampicillin 22.9%, ciprofloxacin 13.4%, cephradine 8.3%, cefuroxime 7.1%, fosfomycin 4.7%, ceftriaxone 3.6%, co-amoxiclav 3.6%, cefotaxime 3.5%, vancomycin 2.6%.
Resistance to all conventionally used antibiotics is increasing, therefore identification of etiological agent and antibiogram is important to treat conjunctivitis and to avoid complications.
确定细菌性结膜炎的病原体，并确定细菌分离物的药敏谱。
这项观察性研究在 2012 年 3 月结束的 12 个月内在 Essa 博士实验室进行。从患有结膜炎的患者的结膜中采集了 200 个样本，在常规培养基上进行培养，并通过 Kirby-Bauer 圆盘扩散法确定细菌分离物的药敏谱。
培养物分析显示，41%的样本培养阳性，革兰阳性菌中金黄色葡萄球菌占 52.5%，表皮葡萄球菌占 30.1%，微球菌占 8.3%。然而，革兰氏阴性菌占 9.1%，其中肺炎克雷伯菌占 5.14%，铜绿假单胞菌占 2.6%，还有 1.36%是其他菌（不动杆菌、嗜血杆菌、大肠杆菌和莫拉氏菌），这是由于隐形眼镜的使用增加和手指不洁。细菌分离物的总体药敏谱表明，氨基糖苷类（庆大霉素、妥布霉素）和新型喹诺酮类是经验性治疗的首选药物，其次是氯霉素，因为药物挑剔的革兰氏阴性菌，如铜绿假单胞菌、不动杆菌和大肠杆菌，都属于结膜分离物。革兰氏阳性菌分离物的耐药谱显示头孢克肟 91.4%、强力霉素 57.9%、复方新诺明 29.3%、氨苄西林 22.9%、环丙沙星 13.4%、头孢唑啉 8.3%、头孢呋辛 7.1%、磷霉素 4.7%、头孢曲松 3.6%、复方阿莫西林 3.6%、头孢噻肟 3.5%、万古霉素 2.6%。
所有常规使用的抗生素的耐药性都在增加，因此确定病原体和药敏谱对于治疗结膜炎和避免并发症非常重要。
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