印度南部一家三级眼科护理中心假单胞菌性眼内炎的抗生素敏感性趋势：一项为期12年的回顾性研究。
Antibiotic sensitivity trends of pseudomonas endophthalmitis in a tertiary eye care center in South India: A 12-year retrospective study.
作者信息
Pan Utsab, Jain Aarti, Gubert Joseph, Kumari Bibha, Sindal Manavi D
机构信息
Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry; Vitreoretina Services, Susrut Eye Foundation and Research Centre, Berhampore, West Bengal, India.
Vitreoretina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry; Vitreoretina Services, Giridhar Eye Institute, Kochi, Kerala, India.
出版信息
Indian J Ophthalmol. 2020 Apr;68(4):627-631. doi: 10.4103/ijo.IJO_1145_19.
PURPOSE
To assess trends in antibiotic sensitivity of pseudomonas and compare multidrug resistance (MDR) between Pseudomonas endophthalmitis cases presenting in two consecutive 6-year time frames in a tertiary center in South India.
METHODS
This is a retrospective comparative series of all Pseudomonas endophthalmitis cases treated from June 2004 to May 2016. Microbiological culture results in all endophthalmitis patients were screened for pseudomonas. Positive cases in the initial 6 and final 6 years were compared for sensitivity to antibiotics and the proportion of MDR. MDR was defined as resistance to at least two different classes of antibiotics.
RESULTS
Pseudomonas accounted for 74 of 389 endophthalmitis cases (19%), 42 in initial 6 and 32 in final 6 years. Sensitivity to ciprofloxacin, ofloxacin, gatifloxacin, moxifloxacin, and ceftazidime was 85.7%, 82.9%, 76.5%, 76.9%, 88.1% up to 2010 which reduced to 75%, 59.4%, 68.8%, 56.3%, 56.3%, respectively, after 2010, being significant for ofloxacin (P = 0.0349) and ceftazidime (P = 0.0028). Susceptibility to amikacin, gentamicin, and tobramycin changed non-significantly from 83.3%, 43.9%, 47.6% to 71.9%, 61.3%, 61.3%, respectively. Twenty of 74 cases (27%) were MDR with 16.7% in first 6 years versus 40.6% in final 6 years. Postoperative MDR cases rose from 10.3% to 50% (P = 0.0048).
CONCLUSION
This study shows rising resistance of Pseudomonas to fluoroquinolones, amikacin, and ceftazidime in endophthalmitis. MDR also showed an upward trend, particularly in postsurgical cases.
目的
评估假单胞菌的抗生素敏感性趋势，并比较印度南部一家三级中心在两个连续的6年时间段内出现的假单胞菌性眼内炎病例的多重耐药性（MDR）。
方法
这是一项对2004年6月至2016年5月期间治疗的所有假单胞菌性眼内炎病例的回顾性比较研究。对所有眼内炎患者的微生物培养结果进行假单胞菌筛查。比较最初6年和最后6年的阳性病例对抗生素的敏感性和多重耐药的比例。多重耐药定义为对至少两种不同类别的抗生素耐药。
结果
389例眼内炎病例中有74例（19%）为假单胞菌感染，最初6年有42例，最后6年有32例。截至2010年，环丙沙星、氧氟沙星、加替沙星、莫西沙星和头孢他啶的敏感性分别为85.7%、82.9%、76.5%、76.9%、88.1%，2010年后分别降至75%、59.4%、68.8%、56.3%、56.3%，氧氟沙星（P = 0.0349）和头孢他啶（P = 0.0028）的差异具有统计学意义。阿米卡星、庆大霉素和妥布霉素的敏感性从83.3%、43.9%、47.6%分别变为71.9%、61.3%、61.3%，差异无统计学意义。74例病例中有20例（27%）为多重耐药，最初6年为16.7%，最后6年为40.6%。术后多重耐药病例从10.3%升至50%（P = 0.0048）。
结论
本研究表明假单胞菌性眼内炎中假单胞菌对氟喹诺酮类、阿米卡星和头孢他啶的耐药性增加。多重耐药也呈上升趋势，尤其是在术后病例中。
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