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外路泪囊鼻腔吻合术中植入双腔硅胶管的微生物学特征。

The Microbiological Profile of Bicanalicular Silicone Tubes Placed During External Dacryocystorhinostomy.

机构信息

Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey

Ankara University Faculty of Medicine, Department of Microbiology, Ankara, Turkey

出版信息

Turk J Ophthalmol. 2021 Aug 27;51(4):212-217. doi: 10.4274/tjo.galenos.2020.47639.

Abstract

OBJECTIVES

To identify microbiological growth on bicanalicular silicone tubes (BST) placed during dacryocystorhinostomy (DCR) surgery and to analyze the association between culture results and surgical outcomes and BST removal time.

MATERIALS AND METHODS

A total of 80 lacrimal drainage systems of 68 patients who had external DCR with bicanalicular silicone intubation were included the study. Twenty-five tubes (31.3%) were removed up to 8 weeks, 28 tubes (35.0%) were removed between 9 and 11 weeks, and the remaining 27 tubes (33.7%) were removed 12 weeks or more after surgery. The tubes were transferred to Stuart medium and sent for microbiologic examination. The disc diffusion method was used to determine antibiotic resistance.

RESULTS

Culture positivity was observed for 96.2% of the tubes. Among a total of 109 isolates, 63 were gram-positive bacteria (57.8%), 37 were gram-negative bacteria (34%), and 9 were fungi (8.2%). The most commonly isolated gram-positive and gram-negative bacteria were (66.6%) and spp. (29.7%), respectively. Penicillin, clindamycin, erythromycin, and tetracycline resistances were higher among gram-positive pathogens. Cephalothin, amoxicillin-clavulanic acid, and ampicillin resistances were higher among gram-negative pathogens. There was no significant difference in terms of the microbiological profile between the three groups of removed tubes. was isolated at a significantly higher rate in patients with surgical failure (p=0.04).

CONCLUSION

Although a variety of agents were isolated from removed BST, gram-positive organisms were more frequent than gram-negatives and fungi. and were the most common gram-positive and gram-negative isolates. Later BST removal was associated with the isolation of significantly more bacterial strains per tube. There was no correlation between multiple infections and surgical failure. was more common in failed DCR cases.

摘要

目的

确定在鼻泪管吻合术(DCR)中放置的双腔硅胶管(BST)上的微生物生长情况,并分析培养结果与手术结果以及 BST 取出时间之间的关系。

材料和方法

本研究纳入了 68 例接受外 DCR 联合双腔硅胶插管的患者的 80 个泪道引流系统。25 个(31.3%)管在 8 周内取出,28 个(35.0%)管在 9-11 周之间取出,其余 27 个(33.7%)管在手术后 12 周或更长时间取出。将管转移到 Stuart 培养基中进行微生物检查。采用纸片扩散法测定抗生素耐药性。

结果

96.2%的管培养阳性。共分离出 109 株,其中革兰阳性菌 63 株(57.8%),革兰阴性菌 37 株(34%),真菌 9 株(8.2%)。最常见的分离革兰阳性菌和革兰阴性菌分别为 (66.6%)和 spp.(29.7%)。革兰阳性病原体对青霉素、克林霉素、红霉素和四环素的耐药性较高。革兰阴性病原体对头孢噻吩、阿莫西林-克拉维酸和氨苄西林的耐药性较高。三组取出的管之间的微生物谱无显著差异。在手术失败的患者中, 分离率显著更高(p=0.04)。

结论

尽管从取出的 BST 中分离出多种药物,但革兰阳性菌的分离率高于革兰阴性菌和真菌。 和 是最常见的革兰阳性和革兰阴性分离株。BST 取出时间越晚,每管分离的细菌菌株数显著增加。多重感染与手术失败之间无相关性。 在 DCR 失败病例中更为常见。

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