Ruiz Caro J M, Cabrejas L, de Hoz M R, Mingo D, Duran S P
Departamento de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
Departamento de Oftalmología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
Arch Soc Esp Oftalmol. 2017 Sep;92(9):419-425. doi: 10.1016/j.oftal.2017.01.004. Epub 2017 Feb 22.
To describe the clinical features, bacterial agents, and antibiotic sensitivity of bacterial keratitis in the Ophthalmology Department at the University Hospital Fundación Jiménez Díaz (HUFJD) in Madrid.
A retrospective observational descriptive study using clinical records and reports of corneal scrapings in patients with bacterial keratitis at the HUFJD conducted between 2009 and 2014.
In a sample of 160 patients, gram-positive bacteria were the most prevalent with 64.3% (n=103). Coagulase negative staphylococcus (20.6%), Staphylococcus aureus (19.4%), and Pseudomonas aeruginosa (12.5%) were the most frequent bacteria. The most common risk factor was the use of contact lenses, followed by disease of the ocular surface, and previous ocular surgeries. The antibiotics to which the bacteria were most commonly susceptible were gentamicin (n=114), cotrimoxazole (n=107), vancomycin (n=106), and ciprofloxacin (n=97). The antibiotics to which the bacteria were most commonly resistant were ampicillin (n=59) and erythromycin (n=45).
In the initial management of bacterial keratitis, the sensitivity and resistance of bacteria to antibiotics should be taken into account. Based on our findings, the use of aminoglycosides, vancomycin and fluoroquinolones is recommended, and, although widely used today, the discontinuation of erythromycin.
描述马德里希门尼斯·迪亚斯基金会大学医院(HUFJD)眼科细菌性角膜炎的临床特征、病原菌及抗生素敏感性。
一项回顾性观察描述性研究,采用2009年至2014年间在HUFJD的细菌性角膜炎患者的临床记录和角膜刮片报告。
在160例患者样本中,革兰氏阳性菌最为常见,占64.3%(n = 103)。凝固酶阴性葡萄球菌(20.6%)、金黄色葡萄球菌(19.4%)和铜绿假单胞菌(12.5%)是最常见的细菌。最常见的危险因素是使用隐形眼镜,其次是眼表疾病和既往眼部手术。细菌最常敏感的抗生素是庆大霉素(n = 114)、复方新诺明(n = 107)、万古霉素(n = 106)和环丙沙星(n = 97)。细菌最常耐药的抗生素是氨苄西林(n = 59)和红霉素(n = 45)。
在细菌性角膜炎的初始治疗中,应考虑细菌对抗生素的敏感性和耐药性。根据我们的研究结果,建议使用氨基糖苷类、万古霉素和氟喹诺酮类药物,并且尽管红霉素如今仍被广泛使用,但应停止使用。