Ulfik Klaudia, Teper Sławomir, Dembski Michał, Nowińska Anna, Wróblewska-Czajka Ewa, Wylęgała Edward
Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Chair and Department of Ophthalmology, Panewnicka 65, 40-760 Katowice, Poland.
District Railway Hospital, Panewnicka 65, 40-760 Katowice, Poland.
J Ophthalmol. 2020 Oct 28;2020:8851570. doi: 10.1155/2020/8851570. eCollection 2020.
This study aimed to analyze the frequency, drug susceptibility, and drug resistance of pathogens causing microbial keratitis (a corneal inflammation) in the Clinical Department of Ophthalmology, Medical University of Silesia, Katowice. Despite intensive treatment, severe inflammation causes irreversible blindness in ∼7% of cases and eye loss (evisceration or enucleation of the eyeball) in ∼1% of cases at our hospital. The choice of a targeted drug depends on the culture result and drug resistance of the microorganism. This was a retrospective observation study. Conjunctival swabs and corneal scrapes were collected between January 1, 2013, and December 31, 2019, in the tertiary reference center for keratitis. The collected data included the type of material received, culture result, and antimicrobial susceptibilities. Of the 2482 samples analyzed, 679 were positive and 1803 were negative. Of the total pathogens isolated, 69.9% were Gram-positive bacteria, 20.8% were Gram-negative bacteria, and 7.1% were fungi. A significant increase in the number of Gram-positive methicillin-resistant and a partial increase in the number of Gram-negative beta-lactams-resistant bacteria were observed. All fungal species were sensitive to amphotericin B, 82.81% were sensitive to voriconazole, and 56.25% were sensitive to fluconazole. Dual drug therapy (levofloxacin and tobramycin) was the first-line treatment. Drug susceptibility testing of the cultured microorganisms is necessary to initiate targeted treatment. Increased drug resistance was observed in this study. In the present study, most bacteria were sensitive to fluoroquinolones. therapy remains the recommended empirical treatment in microbial keratitis. According to our study, voriconazole remains a first-line antifungal drug, when a fungal infection is suspected.
本研究旨在分析卡托维兹西里西亚医科大学眼科临床科室中引起微生物性角膜炎（一种角膜炎症）的病原体的频率、药敏性和耐药性。尽管进行了强化治疗，但在我院，严重炎症仍会导致约7%的病例出现不可逆性失明，约1%的病例出现眼球摘除（眼球摘除或眼球剜除）。靶向药物的选择取决于微生物的培养结果和耐药性。这是一项回顾性观察研究。于2013年1月1日至2019年12月31日在角膜炎三级转诊中心收集结膜拭子和角膜刮片。收集的数据包括所接收材料的类型、培养结果和抗菌药敏性。在分析的2482份样本中，679份为阳性，1803份为阴性。在分离出的病原体总数中，69.9%为革兰氏阳性菌，20.8%为革兰氏阴性菌，7.1%为真菌。观察到耐甲氧西林革兰氏阳性菌数量显著增加，耐β-内酰胺革兰氏阴性菌数量部分增加。所有真菌种类对两性霉素B敏感，82.81%对伏立康唑敏感，56.25%对氟康唑敏感。双联药物治疗（左氧氟沙星和妥布霉素）是一线治疗方法。对培养的微生物进行药敏试验对于启动靶向治疗是必要的。本研究中观察到耐药性增加。在本研究中，大多数细菌对氟喹诺酮类敏感。在微生物性角膜炎中， 治疗仍然是推荐的经验性治疗方法。根据我们的研究，当怀疑有真菌感染时，伏立康唑仍然是一线抗真菌药物。
