Bhattacharyya Anusuya, Sarma Phulen, Sarma Bhaswati, Kumar Subodh, Gogoi Tapan, Kaur Hardeep, Prajapat Manisha
Department of Ophthalmology, GMCH-32.
Department of Pharmacology, PGIMER, Chandigarh.
Medicine (Baltimore). 2020 Feb;99(7):e18570. doi: 10.1097/MD.0000000000018570.
Acute conjunctivitis is inflammation of conjunctiva of less than 3 to 4 weeks duration, characterized by cellular infiltration and exudation. It may also result into corneal, lid or orbital involvement which may lead to various complications.A hospital based prospective study was conducted in Assam Medical College and Hospital with 110 culture proven acute bacterial conjunctivitis cases. Primary objective was to evaluate the bacteriological pattern and secondary objectives were to evaluate seasonal variation, association of different organisms with various complications and antibiotic sensitivity pattern of the isolates.Maximum frequency of bacterial conjunctivitis observed from May to September. SA was the predominant organism isolated throughout the year (32.1%). Commonest single organism isolates were SE (26.1%) and SA (21.6%). True membrane formation was significantly associated with CD (P < .05), whereas pseudo-membrane formation was associated with SA and STBH isolation (P < .05). Isolation of SE, SA, and PA was associated with corneal involvement (P < .05). Lid involvement was seen with SA and Diphtheroid, whereas SP isolation was associated with concomitant dacryocystitis (P < .05). All the major organisms were (SE, SA, D, STBH, SP) highly sensitive to amino-glycosides, cephalosporins, chloromphenicol, vancomycin and linezolid, whereas high level of resistance was seen towards fluroquinolones (ciprofloxacin and moxifloxacin).All acute bacterial conjunctivitis cases don't require antibiotic therapy. In case if required, periodical culture and sensitivity may guide initial pre-emptive antibiotic therapy. Further choice of antibiotic should be govern by culture and sensitivity status.
急性结膜炎是指结膜炎症持续时间少于3至4周，其特征为细胞浸润和渗出。它还可能导致角膜、眼睑或眼眶受累，进而引发各种并发症。在阿萨姆医学院和医院进行了一项基于医院的前瞻性研究，研究对象为110例经培养证实的急性细菌性结膜炎病例。主要目的是评估细菌学模式，次要目的是评估季节变化、不同病原体与各种并发症的关联以及分离菌株的抗生素敏感性模式。细菌性结膜炎的最高发病频率出现在5月至9月。金黄色葡萄球菌是全年分离出的主要病原体（32.1%）。最常见的单一病原体分离株是表皮葡萄球菌（26.1%）和金黄色葡萄球菌（21.6%）。真膜形成与棒状杆菌显著相关（P<0.05），而假膜形成与金黄色葡萄球菌和嗜麦芽窄食单胞菌的分离有关（P<0.05）。表皮葡萄球菌、金黄色葡萄球菌和铜绿假单胞菌的分离与角膜受累有关（P<0.05）。金黄色葡萄球菌和类白喉杆菌可导致眼睑受累，而肺炎链球菌的分离与伴发泪囊炎有关（P<0.05）。所有主要病原体（表皮葡萄球菌、金黄色葡萄球菌、棒状杆菌、嗜麦芽窄食单胞菌、肺炎链球菌）对氨基糖苷类、头孢菌素类、氯霉素、万古霉素和利奈唑胺高度敏感，而对氟喹诺酮类（环丙沙星和莫西沙星）耐药性较高。并非所有急性细菌性结膜炎病例都需要抗生素治疗。如果需要，定期培养和药敏试验可指导初始的预防性抗生素治疗。抗生素的进一步选择应根据培养和药敏情况来决定。
