Knauf H P, Silvany R, Southern P M, Risser R C, Wilson S E
Departments of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, USA.
Cornea. 1996 Jan;15(1):66-71.
Ciprofloxacin 0.3% ophthalmic solution has been shown to be effective in the treatment of bacterial keratitis and conjunctivitis, and many physicians use ciprofloxacin as sole therapy in these conditions. In this retrospective study, we found seven of 84 isolates from corneal and conjunctival cultures that were resistant to ciprofloxacin. All of the resistant organisms were gram positive. Six of the isolates (Staphylococcus aureus, Staphylococcus hominis, and four isolates of the Streptococcus viridans group) were from corneal cultures, and one (Staphylococcus aureus) was from a conjunctival culture. Yearly records of systemic isolates from 1988 to 1993 (n = 35,308) demonstrated a statistically significant decrease in susceptibility for several organisms that are common pathogens in the conjunctiva and cornea: Pseudomonas aeruginosa (95-90%, p = 0.001); Staphylococcus aureus (96-87%, p < 0.0001); Staphylococcus spp., coagulase negative (97-81%, p < 0.0001); Enterococcus spp. (92-79%, p < 0.0001); Acinetobacter anitratus (97-77%, p = 0.0006); and Enterobacter cloacae (100-96%, p = 0.03). Although the susceptibility of corneal and conjunctival isolates in this series remained relatively high (91.7%), a much larger series of systemic isolates that are common ocular pathogens revealed a statistically significant increase in resistance to ciprofloxacin over the preceding 5 years.
0.3%环丙沙星滴眼液已被证明对细菌性角膜炎和结膜炎的治疗有效，许多医生在这些病症中将环丙沙星作为唯一治疗药物。在这项回顾性研究中，我们从角膜和结膜培养物的84株分离菌中发现7株对环丙沙星耐药。所有耐药菌均为革兰氏阳性菌。其中6株分离菌（金黄色葡萄球菌、人葡萄球菌和4株草绿色链球菌）来自角膜培养物，1株（金黄色葡萄球菌）来自结膜培养物。1988年至1993年（n = 35308）全身分离菌的年度记录显示，几种常见于结膜和角膜的病原体对环丙沙星的敏感性出现了具有统计学意义的下降：铜绿假单胞菌（95% - 90%，p = 0.001）；金黄色葡萄球菌（96% - 87%，p < 0.0001）；凝固酶阴性葡萄球菌属（97% - 81%，p < 0.0001）；肠球菌属（92% - 79%，p < 0.0001）；鲍曼不动杆菌（97% - 77%，p = 0.0006）；阴沟肠杆菌（100% - 96%，p = 0.03）。尽管该系列中角膜和结膜分离菌的敏感性仍相对较高（91.7%），但一系列数量更多的常见眼部病原体全身分离菌显示，在过去5年中对环丙沙星的耐药性出现了具有统计学意义的增加。
