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白内障手术后眼内炎的微生物学分析(预防性前房内应用莫西沙星)

Microbiological Profile of Post-cataract Surgery Endophthalmitis with Usage of Prophylactic Intracameral Moxifloxacin.

机构信息

Department of Retina and Vitreous, Aravind Eye Hospital, Madurai, India.

Trilochan Nethralaya, Sambalpur, Odisha.

出版信息

Ocul Immunol Inflamm. 2024 Aug;32(6):796-802. doi: 10.1080/09273948.2023.2170249. Epub 2023 Feb 7.

Abstract

PURPOSE

To study the effect of prophylactic intracameral moxifloxacin (ICM) on microbiological profile and antimicrobial sensitivity of culture-proven postoperative endophthalmitis (POE).

METHODS

This study evaluated culture-proven POE diagnosed within 6 weeks of cataract surgery over two periods, period-1 (January 2010-March 2015) and period-2 (April 2015-December 2019), before and after introduction of prophylactic ICM, respectively.

RESULTS

In period-1, 100 cases of culture-positive POE were reported (1 in 4879, 0.02%), while 20 cases (1 in 24635, 0.004%) were reported in period-2 (5-fold reduction, < .001). The cumulative culture positivity rate decreased from 27.6% to 17.1% (1.6-fold) . Coagulase-negative Staphylococci (CoNS) were significantly reduced ( = .005).

CONCLUSIONS

ICM reduced the incidence of culture-proven POE, CoNS in particular. In future, POE caused by rarer pathogens may become more prevalent due to reduction in the rate of commoner and more virulent pathogens with use of intracameral antibiotics. The moxifloxacin sensitivity of CONS did not show change with the use of ICM. Studies with larger population of POE will be more helpful to understand the trend better.

摘要

目的

研究预防性前房内莫西沙星(ICM)对培养证实的术后眼内炎(POE)的微生物谱和抗菌敏感性的影响。

方法

本研究评估了在白内障手术后 6 周内诊断出的培养证实的 POE,分为两个时期,第 1 期(2010 年 1 月至 2015 年 3 月)和第 2 期(2015 年 4 月至 2019 年 12 月),分别在引入预防性 ICM 之前和之后。

结果

第 1 期报告了 100 例培养阳性 POE(1/4879,0.02%),而第 2 期报告了 20 例(1/24635,0.004%)(5 倍减少,<0.001)。累积培养阳性率从 27.6%降至 17.1%(1.6 倍)。凝固酶阴性葡萄球菌(CoNS)显著减少(=0.005)。

结论

ICM 降低了培养证实的 POE 的发生率,尤其是 CoNS。在未来,由于使用前房内抗生素减少了常见且更具毒性的病原体,由于罕见病原体引起的 POE 可能会变得更为普遍。ICM 使用后 CoNS 对莫西沙星的敏感性没有变化。具有更大 POE 人群的研究将有助于更好地了解趋势。

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