Fan Caixia, Yang Baoxia, Huang Yusen
Weifang Medical University, Weifang 261053, China.
State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Qingdao 266071, China.
J Ophthalmol. 2020 Apr 17;2020:1780498. doi: 10.1155/2020/1780498. eCollection 2020.
Bacteria associated with postoperative endophthalmitis mostly originate from the normal bacterial flora of the patient's conjunctiva and eyelids, so the incidence of endophthalmitis may be reduced by eliminating the ocular and adnexal flora before surgery. We assessed the effectiveness of eyedrops of 0.5% levofloxacin and 5.0% povidone-iodine (PVI) in reducing conjunctival bacterial flora by metagenomic analysis. A total of 2.4 × 10 high-quality sequencing reads were generated from 93 conjunctival samples obtained from 31 eyes scheduled for cataract surgery before prophylactic therapy (group 1), after administration of 0.5% levofloxacin eyedrops into the conjunctival sac 8 times before surgery (group 2), and at 3 minutes after instillation of 5.0% PVI solution in the conjunctival sac (group 3) followed by surgery irrigation. The alpha diversity and beta diversity results demonstrated that group 3 had the least richness and biodiversity. , and were predominant in all samples. The relative abundance of these bacterial species was 30.94%, 27.48%, 5.26%, 4.55%, and 2.61% in group 1, 16.32%, 44.10%, 2.19%, 5.39%, and 0.97% in group 2, and 5.90%, 65.55%, 0.39%, 5.36%, and 0.10% in group 3, respectively. The most easily and difficultly eliminated were and , respectively. In conclusion, the metagenomic analysis using high-throughput sequencing provides a scientific way for evaluating the effectiveness of a disinfection method from the perspective of analyzing the composition and diversity of the conjunctival microbiome. Despite the use of preoperative antisepsis regimens, the ocular surface of patients receiving cataract surgery could not be rendered completely aseptic, indicating that more strict disinfection methods need to be adopted to reduce the risk for anterior chamber contamination and endophthalmitis after cataract surgery.
与术后眼内炎相关的细菌大多源自患者结膜和眼睑的正常菌群，因此术前消除眼表及附属器菌群可降低眼内炎的发生率。我们通过宏基因组分析评估了0.5%左氧氟沙星滴眼液和5.0%聚维酮碘（PVI）滴眼液在减少结膜细菌菌群方面的有效性。对31只计划行白内障手术的眼睛在预防性治疗前（第1组）、术前结膜囊内滴入0.5%左氧氟沙星滴眼液8次后（第2组）以及结膜囊内滴入5.0% PVI溶液3分钟后（第3组）并随后进行手术冲洗时获取的93份结膜样本进行了高通量测序，共产生了2.4×10个高质量测序读数。α多样性和β多样性结果表明，第3组的丰富度和生物多样性最低。在所有样本中， 、 、 、 、 占主导地位。这些细菌种类在第1组中的相对丰度分别为30.94%、27.48%、5.26%、4.55%和2.61%，在第2组中分别为16.32%、44.10%、2.19%、5.39%和0.97%，在第3组中分别为5.90%、65.55%、0.39%、5.36%和0.10%。最易和最难消除的分别是 和 。总之，使用高通量测序的宏基因组分析从分析结膜微生物组的组成和多样性角度为评估消毒方法的有效性提供了一种科学方法。尽管采用了术前抗菌方案，但接受白内障手术患者的眼表仍无法完全无菌，这表明需要采用更严格的消毒方法以降低白内障手术后前房污染和眼内炎的风险。
