Barría von-B Fernando, Chabouty Henriette, Moreno René, Ortiz Freddy, Barría M Fernando
Rev Chilena Infectol. 2015 Apr;32(2):150-7. doi: 10.4067/S0716-10182015000300003.
Endophtalmitis post cataract surgery is one of most feared and devastating complications resulting in serious consequences and an uncertain visual prognosis. Antimicrobial prophylaxis against endophtalmitis must be based on the best knowledge of conjuntival microbiota.
To establish microbiological basis for the best antibiotic prophylaxis to prevent endophthalmitis in cataract surgery.
A descriptive, cross-sectional, prospective study. A preoperative conjunctival sample was taken from the lower fornix of 118 pacients, sowing it immediately in culture media. Identification of growing colonies and susceptibility testing were performed by manual or automated methods.
106 (89.8%) of 118 preoperative cultures were positive. 159 bacteria were isolated in single or mixed flora, with 95% of Gram positive organisms. Staphylococci represented 76.1% of isolated bacteria, with 82.6% of coagulase-negative staphylococci (SCN) and 17.4% of Staphylococcus aureus. Forty two percent of SCN and 38% of S. aureus were methicillin resistan; both groups showed high susceptibility to tobramycin and fourth-generation fluoroquinolones.
we recommend the use of topical tobramycin as pre-operative antimicrobial prophylaxis associated with povidone-iodine antisepsis. A fourth-generation quinolone is recommended when there is risk of infection.
白内障手术后眼内炎是最令人恐惧且具有破坏性的并发症之一，会导致严重后果以及不确定的视力预后。预防眼内炎的抗菌药物必须基于对结膜微生物群的最佳了解。
建立最佳抗生素预防措施的微生物学依据，以预防白内障手术中的眼内炎。
一项描述性、横断面、前瞻性研究。从118例患者的下穹窿部采集术前结膜样本，并立即接种于培养基中。通过手动或自动方法进行生长菌落的鉴定和药敏试验。
118例术前培养中有106例（89.8%）呈阳性。共分离出159株细菌，以单一或混合菌群形式存在，其中95%为革兰氏阳性菌。葡萄球菌占分离细菌的76.1%，其中凝固酶阴性葡萄球菌（SCN）占82.6%，金黄色葡萄球菌占17.4%。42%的SCN和38%的金黄色葡萄球菌对甲氧西林耐药；两组对妥布霉素和第四代氟喹诺酮类药物均表现出高敏感性。
我们建议使用局部妥布霉素作为术前抗菌预防措施，并联合聚维酮碘消毒。当存在感染风险时，推荐使用第四代喹诺酮类药物。
