【摘要】 目的　回顾分析细菌性角膜炎致病菌菌属的分布及变化。方法　对 1989～ 1998年间送检的 2 2 2 0份细菌性角膜炎患者角膜细菌培养标本进行革兰染色及分类 ;对不同菌属的分布及变化情况进行回顾性分析。结果　在 2 2 2 0份培养的角膜细菌标本中 ,培养阳性菌株 4 90株 ,阳性率为2 2 1%。其中革兰阳性球菌 2 5 0株 ,占 5 1 0 % ;革兰阴性球菌 2株 ,占 0 4 % ;革兰阴性杆菌 193株 ,占39 4 % ;革兰阳性杆菌 4 5株 ,占 9 2 %。假单胞菌属的检出率最高 ,占 32 2 % ,其次为凝固酶阴性葡萄球菌属为 18 6 % ,第 3位为肺炎球菌 12 0 %。 10年中 ,革兰阳性球菌检出率呈上升趋势 ,革兰阴性杆菌检出率则呈下降趋势。结论　假单胞菌属及凝固酶阴性葡萄球菌属仍是细菌性角膜炎较常见的致病菌 ,革兰阴性杆菌检出率下降与革兰阳性球菌检出率升高趋势应引起临床眼科医师的注意更多还原

【Abstract】 Objective To study the distribution and shifting trends of corneal bacterial isolates from bacterial keratitis retrospectively. Methods The data of bacterial cultures of 2 220 corneal isolates from January, 1989 to December,1998 were reviewed. Results During this 10 year period, 2 220 consecutive corneal cultures were obtained, and a positive culture was recovered in 490 isolates, the positive rate being 22 1%. In the 490 positive cultures, Gram positive cocci and Gram negative bacilli represented 51 0% and 39 4% respectively. Gram positive bacilli was 9 2%. Pseudomonas aeruginosa was isolated the most commonly in the corneal isolates (32 2%), followed by coagulase negative staphylococcus (18 6%). Streptococcus pneumoniae represented 12 0%. During this period, we documented a gradual increase in the number of Gram positive cocci coupled with a decrease of the number of Gram negative bacilli. Conclusion Pseudomonas aeruginosa and coagulase negative staphylococcus are the most common pathogens in bacterial keratitis in the north part of China. At present, the increased recovery of Gram positive cocci and decreased of Gram negative bacilli from keratitis isolates present an important challenge to the ophthalmology.更多还原