一名硬性透气性角膜接触镜佩戴者穿透性角膜移植术后发生木糖氧化产碱杆菌性角膜炎。
Alcaligenes xylosoxidans keratitis post penetrating keratoplasty in a rigid gas permeable lens wearer.
作者信息
Lin A, Driebe W T, Polack P
机构信息
Department of Ophthalmology, University of Florida College of Medicine, Gainesville 32610-0284, USA.
出版信息
CLAO J. 1998 Oct;24(4):239-41.
PURPOSE
We report a case of Alcaligenes xylosoxidans keratitis following penetrating keratoplasty in a rigid gas permeable (RGP) lens wearer.
METHODS
A 61 year old RGP lens wearer with a history of nonresponsive keratitis of the right eye which involved the graft margin was referred to us for treatment. Corneal cultures revealed growth of a gram-negative rod on the fifth day and the organism was subsequently identified as Alcaligenes xylosoxidans, which was resistant to most antibiotics and sensitive only to Bactrim, Timentin, and imipenem.
RESULTS
Clinical improvement was observed within 24 hours after treatment with the use of topical i.v. Bactrim and topical i.v. Timentin 2% alternating every 30 minutes. Complete resolution of the infection with mild scarring was observed 6 weeks after treatment.
CONCLUSIONS
Alcaligenes xylosoxidans is a potential cause of bacterial keratitis which should be considered in cases of nonresponsive gram-negative keratitis. The addition of topical Bactrim or Timentin may need to be considered in such cases.
目的
我们报告一例在硬性透气性（RGP）隐形眼镜佩戴者穿透性角膜移植术后发生木糖氧化产碱杆菌性角膜炎的病例。
方法
一名61岁的RGP隐形眼镜佩戴者，右眼曾患对治疗无反应的角膜炎且累及植片边缘，前来我院接受治疗。角膜培养在第五天显示出革兰氏阴性杆菌生长，该微生物随后被鉴定为木糖氧化产碱杆菌，它对大多数抗生素耐药，仅对复方新诺明、替卡西林/克拉维酸和亚胺培南敏感。
结果
在使用局部静脉注射复方新诺明和每30分钟交替使用2%局部静脉注射替卡西林/克拉维酸治疗后24小时内观察到临床改善。治疗6周后观察到感染完全消退，伴有轻度瘢痕形成。
结论
木糖氧化产碱杆菌是细菌性角膜炎的一个潜在病因，在革兰氏阴性角膜炎治疗无反应的病例中应予以考虑。在此类病例中可能需要考虑加用局部复方新诺明或替卡西林/克拉维酸。
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