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16 年来在印度南部一家三级眼科护理中心的非病毒性结膜炎的微生物谱和抗生素药敏模式。

Microbiological spectrum and antibiotic susceptibility patterns of non-viral conjunctivitis over 16 years at a tertiary eye care center in Southern India.

机构信息

Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Hyderabad, Telangana, 500034, India.

Manipal Academy of Higher Education, Manipal, 576104, India.

出版信息

Int Ophthalmol. 2023 Oct;43(10):3717-3724. doi: 10.1007/s10792-023-02781-4. Epub 2023 Jul 3.

Abstract

PURPOSE

To determine the trends in the microbial spectrum and antibacterial susceptibility patterns of non-viral conjunctivitis over 16 years.

METHODS

Microbiology data were reviewed from 2006-2021 for all the patients with clinically and culture-proven infectious conjunctivitis. Conjunctival swabs and/or conjunctival scrapings were collected for microbiological workup, and the demographic and antibiotic susceptibility data were extracted from the EMR (Electronic Medical Record). For statistical analysis, χ-test was performed.

RESULTS

Of the 1711 patients, 814 (47.57%) were culture positive and 897 (52.43%) were culture negative. Of the total culture-proven conjunctivitis cases, 775/814 (95.20%) were bacteria, and 39/814 (4.80%) were fungi. Among these bacterial isolates, 75.74% were gram-positive bacteria, while 24.26% were gram negative. The predominant gram-positive pathogens isolated were S. epidermidis (16.7%), S. aureus (17.9%) (p < 0.05), and S. pneumoniae (18.2%), while Haemophilus spp. (36.2%) (p < 0.05) was the most often isolated gram-negative bacteria (36.2%), and Aspergillus spp. was the most commonly isolated fungus (50%). The susceptibility of gram-positive bacteria to cefazoline increased from 90.46 to 98% (p = 0.01), whereas the susceptibility for gatifloxacin decreased in both gram-positive (81-41%; p < 0.0001) and gram-negative bacteria (73-58%; p = 0.02).

CONCLUSIONS

Increasing resistance of ocular isolates to mainstay antibiotics is a concern, and this data can assist healthcare practitioners in making informed choices regarding the treatment of ocular infections with ophthalmic antibiotics.

摘要

目的

确定 16 年来非病毒性结膜炎的微生物谱和抗菌药物敏感性趋势。

方法

对 2006 年至 2021 年间所有经临床和培养证实为传染性结膜炎的患者的微生物数据进行了回顾性分析。采集结膜拭子和/或结膜刮片进行微生物检查,并从电子病历(EMR)中提取人口统计学和抗生素敏感性数据。采用卡方检验进行统计学分析。

结果

在 1711 例患者中,814 例(47.57%)培养阳性,897 例(52.43%)培养阴性。在所有培养证实的结膜炎病例中,775/814 例(95.20%)为细菌,39/814 例(4.80%)为真菌。在这些细菌分离物中,75.74%为革兰氏阳性菌,24.26%为革兰氏阴性菌。分离出的主要革兰氏阳性病原体依次为表皮葡萄球菌(16.7%)、金黄色葡萄球菌(17.9%)(p<0.05)和肺炎链球菌(18.2%),而嗜血杆菌属(36.2%)(p<0.05)是最常分离到的革兰氏阴性菌(36.2%),曲霉菌属是最常分离到的真菌(50%)。革兰氏阳性菌对头孢唑林的敏感性从 90.46%增加到 98%(p=0.01),而革兰氏阳性菌(81-41%;p<0.0001)和革兰氏阴性菌(73-58%;p=0.02)对加替沙星的敏感性均下降。

结论

眼部分离株对抗生素的耐药性增加令人担忧,这些数据可以帮助临床医生在选择眼科抗生素治疗眼部感染时做出明智的选择。

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