Toribio Alvaro, Marrodán Teresa, Fernández-Natal Isabel, Martínez-Blanco Honorina, Rodríguez-Aparicio Leandro, Ferrero Miguel Á
Department of Ophthalmology, University Hospital of León, León 24071, Spain.
Department of Clinical Microbiology, University Hospital of León, León 24071, Spain.
Int J Ophthalmol. 2019 May 18;12(5):765-773. doi: 10.18240/ijo.2019.05.10. eCollection 2019.
To identify the spectrum and susceptibility pattern of isolated microorganisms from conjunctival flora of anophthalmic patients.
A cross-sectional clinical study including 60 patients with unilateral anophthalmia. Patients with use of antibiotic drops in their socket during the last month were also included. From each patient, three microbiological samples were taken from the lower conjunctival sac (healthy eye, pre-prosthesis, and retro-prosthesis space of socket). The 180 samples obtained were cultured. Isolates were identified and their antibiotic sensitivities were determined.
A total of 251 isolates were recovered (62 isolates from healthy eye, 93 from pre-prosthesis, and 96 from retro-prosthesis space). The most common organism was , in both healthy eyes (64.5%) and sockets (45.5%). Altogether, coagulase-positive , and Gram-negative bacteria accounted for less than 15% of isolates in healthy eyes and more than 35% in sockets. Regarding the antibiotic sensitivities, there were no significant differences between isolates from sockets and healthy eyes. Nine patients recognized the use of self-prescribed antibiotic drops in their socket. In the healthy eyes of these subjects, Gram-positive microorganisms showed significantly greater resistance to aminoglycosides and tetracycline.
Sockets of anophthalmic patients show a greater number of pathogens compared to healthy eyes. The use of antibiotic drops in the socket promotes a resistant flora not only in the socket but also in the healthy eye. Quinolones and macrolides may be better therapeutic options than aminoglycosides for treating conjunctivitis of anophthalmic sockets, since these antibiotics are less active against .
确定无眼球患者结膜菌群中分离出的微生物谱及药敏模式。
一项横断面临床研究,纳入60名单侧无眼球患者。包括过去一个月内眼窝使用过抗生素滴眼液的患者。从每位患者的下结膜囊(健眼、义眼植入前、义眼植入后眼窝间隙)采集三份微生物样本。对获取的180份样本进行培养。鉴定分离菌并测定其抗生素敏感性。
共分离出251株菌株(健眼分离出62株,义眼植入前分离出93株,义眼植入后眼窝间隙分离出96株)。最常见的微生物在健眼(64.5%)和眼窝(45.5%)中均为 。总体而言,凝固酶阳性 以及革兰氏阴性菌在健眼中占分离菌不到15%,在眼窝中占比超过35%。关于抗生素敏感性,眼窝分离菌与健眼分离菌之间无显著差异。9名患者承认在眼窝使用过自行开具的抗生素滴眼液。在这些受试者的健眼中,革兰氏阳性微生物对氨基糖苷类和四环素的耐药性显著更高。
与健眼相比,无眼球患者的眼窝中病原体数量更多。眼窝使用抗生素滴眼液不仅会促使眼窝出现耐药菌群,也会使健眼出现耐药菌群。喹诺酮类和大环内酯类药物可能比氨基糖苷类药物更适合治疗无眼球眼窝的结膜炎,因为这些抗生素对 的活性较低。