Miño de Kaspar H, Kollmann M, Klauss V
Augenklinik, Universität München.
Ophthalmologe. 1993 Dec;90(6):726-36.
The fast and precise identification of infectious agents and their characterization is of upmost importance for the diagnosis and therapy of infectious endophthalmitis. A preliminary estimate of the most probable predominant agents may improve the choice of an adequate antimicrobial therapy prior to definitive microbiological analysis in culture media. A prospective study was performed in 46 patients with endophthalmitis. During surgery mostly undiluted samples were inoculated in 10 different culture media. Microscopic investigation and laboratory processing were performed within the next 10-120 min. A presumptive classification based on immediate direct microscopy and a preliminary recommendation on treatment were achieved in 25 cases. Culture yielded positive results in 38 cases (83%). In 8 cases the inoculates remained negative. Most of the positive cultures (92%) contained only gram-positive bacteria, including 10 cases of mixed gram-positive infections. In 2 samples bacteria and fungi were present, while 2 contained fungi only. Of 8 posttraumatic eyes, 4 were infected with Bacillus spp. The results show that specific therapeutic approaches are required. Direct inoculation of surgical culture media combined with immediate microscopic investigation permits a fast and precise microbiological diagnosis.
快速、准确地鉴定感染病原体及其特征对于感染性眼内炎的诊断和治疗至关重要。在进行培养基的确定性微生物分析之前，对最可能的主要病原体进行初步评估可能会改善适当抗菌治疗的选择。对46例眼内炎患者进行了一项前瞻性研究。手术期间，大多将未稀释的样本接种于10种不同的培养基中。在接下来的10 - 120分钟内进行显微镜检查和实验室处理。25例病例实现了基于即时直接显微镜检查的推定分类和初步治疗建议。培养有38例（83%）获得阳性结果。8例接种物仍为阴性。大多数阳性培养物（92%）仅含有革兰氏阳性菌，包括10例革兰氏阳性菌混合感染。2份样本中存在细菌和真菌，而2份样本仅含有真菌。8只外伤眼中，4只感染了芽孢杆菌属。结果表明需要采用特定的治疗方法。手术培养基的直接接种结合即时显微镜检查可实现快速、准确的微生物诊断。
