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儿童感染性眼内炎的临床及病原学特点:一项回顾性分析。

Clinical and pathogenic characteristics of infectious endophthalmitis in children: A retrospective analysis.

机构信息

Department of Diabetic Ophthalmology, Hebei Ophthalmology Key Lab, Hebei Eye Hospital, Xingtai, Hebei, China.

Department of Ophthalmology, Peking University International Hospital, Life Science Park of Zhong Guancun, Changping District, Beijing, China.

出版信息

Medicine (Baltimore). 2024 Jun 14;103(24):e38456. doi: 10.1097/MD.0000000000038456.

Abstract

Infective endophthalmitis is an ophthalmic infection that in severe cases can cause complete loss of vision. In children, the defense against infection is low and eye tissue is not fully developed, leading to increased vulnerability to endophthalmitis. Children may be unable to understand the symptoms; thus, developing a method for prevention and treatment of this disease in children is important. Therefore, we analyzed the clinical and pathogenic characteristics of infectious endophthalmitis in children and provided evidence for clinical treatment. The clinical data of 78 children (78 eyes) with infectious endophthalmitis were retrospectively analyzed. The clinical characteristics, pathogen distribution, drug sensitivity, clinical medication, and treatments were summarized and analyzed. In total, 74 (94.87%) had ocular infections caused by trauma and 75 (96.15%) were from rural townships. A total of 108 sterile specimens were examined, with a positive detection rate of 37.04%. The sensitivity rates of Gram-positive cocci and bacilli to vancomycin were 100%. The sensitivity rates of Gram-negative bacilli to ceftazidime, piperacillin/tazobactam, amikacin, gentamicin, ciprofloxacin, and levofloxacin were 100%. Of the 78 patients, 53 (67.95%) received intravitreal injection and 54 (69.23%) underwent vitrectomy. Trauma is the main factor leading to infectious endophthalmitis in children, wherein Gram-positive bacteria are the most common pathogens. Thus, a timely understanding of the pathogen and drug sensitivity is needed. Intravitreal injection and vitrectomy are effective treatments.

摘要

感染性眼内炎是一种眼部感染,如果病情严重,可导致完全失明。儿童的抗感染能力较低,眼部组织尚未完全发育,因此更容易受到眼内炎的影响。儿童可能无法理解症状,因此,为儿童开发这种疾病的预防和治疗方法很重要。因此,我们分析了儿童感染性眼内炎的临床和病原学特征,为临床治疗提供了依据。回顾性分析了 78 例(78 眼)儿童感染性眼内炎的临床资料。总结并分析了其临床特征、病原菌分布、药敏结果、临床用药及治疗情况。共 74 例(94.87%)因眼外伤引起眼内感染,75 例(96.15%)来自农村乡镇。共检查 108 份无菌标本,阳性检出率为 37.04%。革兰阳性球菌和杆菌对万古霉素的敏感率均为 100%。革兰阴性杆菌对头孢他啶、哌拉西林/他唑巴坦、阿米卡星、庆大霉素、环丙沙星和左氧氟沙星的敏感率均为 100%。78 例患者中,53 例(67.95%)接受了眼内注射,54 例(69.23%)接受了玻璃体切除术。外伤是导致儿童感染性眼内炎的主要因素,其中革兰阳性菌是最常见的病原体。因此,及时了解病原体和药敏情况非常重要。眼内注射和玻璃体切除术是有效的治疗方法。

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