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抗生素耐药性:细菌性眼部感染治疗中的新挑战。

Antibiotic Resistance: New Challenge in the Management of Bacterial Eye Infections.

作者信息

Talukder A K, Sultana Z, Jahan I, Khanam M, Rahman M, Rahman M F, Rahman M B

机构信息

Dr Md Abdul Khaleque Talukder, Ex-Associate Professor, Ophthalmology, Mymensingh Medical College, Mymensingh, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2017 Jan;26(1):29-36.

Abstract

Ophthalmologists are still facing difficulties in managing bacterial eye infections. The study was designed for the isolation and identification of bacteria from infected eyes and observation of the sensitivity and resistant pattern. This cross sectional study was performed among 160 patients of suspected bacterial eye infection at Dr. K. Zaman BNSB Eye Hospital, Mymensingh and Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh from March, 2010 to June, 2014. After collection of the samples from suspected infected eyes, it was nourished into nutrient broth in shaking incubator for three hours and then cultured into nutrient agar media followed by Mannitol salt agar, MacConkey's agar and blood agar. Bacteria were categorized by colony characteristics and Gram staining. Antibiogram was performed by disc diffusion method on Mueller Hinton agar media. McFarland Equivalence Turbidity Standard was maintained. The efficacy of the drug was evaluated by measuring the diameter of the zone of inhibition surrounding the disc. Ten percent Staphylococcus species isolates was resistant to Gatifloxacin, Gentamicin, Tobramycin and Cloxacillin, 26.0% to Ciprofloxacin, 40.0% to Azythromycin and Moxifloxacin, 58.0% to Cefixime and 64.0% to Cephalexin. Methicillin resistant Staphylococcus aureus was 62.8%. About 24.0% Streptococcus species isolates was resistant to Gatifloxacin, 33.3% to Azythromycin, Ciprofloxacin, Gentamycin, Moxifloxacin and Tobramycin, 52.4% to Cefixime and 71.4% to Cephalexin. About 9.0% of Pseudomonas species was resistant to Gatifloxacin and Tobramycin, 14.7% to Ciprofloxacin, 26.5% to Cefixime, 29.4% to Gentamicin and Moxifloxacin, 44.1% to Azythromycin and 82.3% to Cephalexin and Cloxacillin. Rational use of antibiotics and proper attentions of concerned authorities are necessary to overcome the emergent ocular situation leaded by antibiotic resistant.

摘要

眼科医生在治疗细菌性眼部感染方面仍面临困难。本研究旨在从感染的眼睛中分离和鉴定细菌,并观察其药敏和耐药模式。这项横断面研究于2010年3月至2014年6月在迈门辛的K. Zaman BNSB眼科医院以及孟加拉国农业大学迈门辛分校的微生物学与卫生学系对160例疑似细菌性眼部感染患者进行。从疑似感染的眼睛采集样本后,将其接种到营养肉汤中,在振荡培养箱中培养3小时,然后接种到营养琼脂培养基上,随后接种到甘露醇盐琼脂、麦康凯琼脂和血琼脂上。根据菌落特征和革兰氏染色对细菌进行分类。采用纸片扩散法在穆勒-欣顿琼脂培养基上进行药敏试验。维持麦克法兰比浊标准。通过测量纸片周围抑菌圈的直径来评估药物的疗效。10%的葡萄球菌分离株对加替沙星、庆大霉素、妥布霉素和氯唑西林耐药,26.0%对环丙沙星耐药,40.0%对阿奇霉素和莫西沙星耐药,58.0%对头孢克肟耐药,64.0%对头孢氨苄耐药。耐甲氧西林金黄色葡萄球菌占62.8%。约24.0%的链球菌分离株对加替沙星耐药,33.3%对阿奇霉素、环丙沙星、庆大霉素、莫西沙星和妥布霉素耐药,52.4%对头孢克肟耐药,71.4%对头孢氨苄耐药。约9.0%的假单胞菌对加替沙星和妥布霉素耐药,14.7%对环丙沙星耐药,26.5%对头孢克肟耐药,29.4%对庆大霉素和莫西沙星耐药,44.1%对阿奇霉素耐药,82.3%对头孢氨苄和氯唑西林耐药。为克服抗生素耐药导致的紧急眼部情况,合理使用抗生素以及相关部门给予适当关注是必要的。

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