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睑板腺功能障碍中的眼表微生物群

Ocular surface microbiome in meibomian gland dysfunction.

作者信息

Watters Grant A, Turnbull Philip R, Swift Simon, Petty Alex, Craig Jennifer P

机构信息

Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.

School of Optometry and Vision Science, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.

出版信息

Clin Exp Ophthalmol. 2017 Mar;45(2):105-111. doi: 10.1111/ceo.12810. Epub 2016 Sep 7.

Abstract

BACKGROUND

To investigate the ocular microbiome in meibomian gland dysfunction in Auckland, New Zealand.

DESIGN

Prospective, cross-sectional, observational, university-based study.

PARTICIPANTS

Participants resident in New Zealand for ≥2 years (n = 157) were classified as normal (n = 66), mild (n = 41) or moderate-to-severe meibomian gland dysfunction (n = 50). Contact lens wear and anterior blepharitis status were recorded, as well as symptoms and clinical features.

METHODS

Bacteria collected from lid margin swabs, before and after gland expression, were isolated and identified by conventional microbiological culture techniques. Aerobic isolates were identified in all 157 participants, and both aerobic and anaerobic bacteria isolated in a subset of 87 subjects.

MAIN OUTCOME MEASURES

Bacterial incidence according to meibomian gland dysfunction status RESULTS: Symptoms, bulbar hyperaemia, conjunctival staining, lipid layer grade and tear film stability, but not corneal staining, showed moderate association with meibomian gland dysfunction severity. Participants with and without meibomian gland dysfunction showed a similar microbiome, unaffected by gland expression. Anterior blepharitis, a common co-morbidity, was not an independent predictor of the microbiome. Sterile cultures were more common in contact lens wearers than non-wearers. The incidence of Staphylococcus aureus was higher than anticipated across all severity groups, and that of coagulase-negative Staphylococcus, Corynebacterium and streptococci was lower.

CONCLUSIONS

Modest differences in relative proportions of bacteria compared with other studies support climatic variations in the ocular surface microbiome. Similarity in microbiome profile, irrespective of meibomian gland dysfunction severity, anterior blepharitis presence or contact lens wear, suggests potential for commonality in treatment.

摘要

背景

调查新西兰奥克兰睑板腺功能障碍患者的眼部微生物群。

设计

前瞻性、横断面、观察性、基于大学的研究。

参与者

在新西兰居住≥2年的参与者(n = 157)被分为正常组(n = 66)、轻度组(n = 41)或中重度睑板腺功能障碍组(n = 50)。记录佩戴隐形眼镜情况和睑缘前部睑炎状态,以及症状和临床特征。

方法

采用传统微生物培养技术分离并鉴定从睑缘拭子在睑板腺按摩前后采集的细菌。对所有157名参与者进行需氧菌分离鉴定,对87名受试者的一个亚组同时进行需氧菌和厌氧菌分离鉴定。

主要观察指标

根据睑板腺功能障碍状态的细菌发生率

结果

症状、球结膜充血、结膜染色、脂质层分级和泪膜稳定性,但不包括角膜染色,与睑板腺功能障碍严重程度呈中度相关。有和没有睑板腺功能障碍的参与者显示出相似的微生物群,不受睑板腺按摩的影响。常见的合并症睑缘前部睑炎不是微生物群的独立预测因素。无菌培养在隐形眼镜佩戴者中比非佩戴者更常见。金黄色葡萄球菌在所有严重程度组中的发生率均高于预期,凝固酶阴性葡萄球菌、棒状杆菌和链球菌的发生率较低。

结论

与其他研究相比,细菌相对比例的适度差异支持眼表微生物群存在气候差异。无论睑板腺功能障碍严重程度、睑缘前部睑炎的存在与否或隐形眼镜佩戴情况如何,微生物群谱相似,提示治疗可能具有共性。

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