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细菌性角膜炎病原学及耐药性分析

The pathogens and its resistance to antibiotics in bacterial keratitis: a 4-year review

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【作者】 梁艳闯王智群李然梁庆丰罗时运邓世靖安莹孙旭光

【Author】 Liang Yanchuang,Wang Zhiqun,Li Ran,Liang Qingfeng,Luo Shiyun,Deng Shijing,An Ying,Sun Xuguang.Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Capital University of Medical Sciences,Beijing 100005,China

【机构】 首都医科大学附属北京同仁眼科中心、北京市眼科研究所首都医科大学附属北京同仁眼科中心、北京市眼科研究所 100005北京研究生中国民航总局民航医学中心100025北京100005北京

【摘要】 目的回顾性地分析细菌性角膜炎致病菌属的分布及其耐药性。方法对1985份细菌性角膜炎患者标本进行细菌培养,并分析培养阳性菌属的分布及其耐药性。结果共培养出细菌279株,阳性率为14.06%;革兰阳性球菌、革兰阳性杆菌、革兰阴性杆菌及革兰阴性球菌分别为119株(42.65%)、58株(20.79%)、98株(35.13%)及4株(1.43%)。假单孢菌属比例最高,为20.07%。细菌对氧氟沙星、环丙沙星、左氧氟沙星及妥布霉素的耐药百分比分别为20.2%、35.9%、15.5%及29.4%。老年组对环丙沙星、左氧氟沙星及妥布霉素的耐药百分比明显高于成人组(χ2=14.744,5.835,19.709;P<0.05)。结论假单孢菌属及葡萄球菌属仍是细菌性角膜炎最常见的致病菌,各种菌属对常用抗生素耐药性均有升高趋势。

【Abstract】 ObjectiveThe biological features,bacterial spectrum and the susceptibility of pathogens vary with the utilization of antibiotics in ophthalmology.It is necessary to analyze the bacterial distribution in eye and resistance regularity to antibiotics.In current paper,we studied the distribution of bacteria isolates from the keratitis in North China and their susceptibility to fluoroquinolones.Methods1985 corneal specimens from patients with bacterial keratitis from January 2001 to December 2004 were cultivated,and the pathogenesis spectrum and resistance of cultured bacteria to antibiotics were analyzed.Results279 of 1985 isolates specimen (from 151 male and 128 female,mean age 45.14 years) were bacterial positive in culture,showing a positive rate of 14.06%.The positive culture outcome of Gram positive cocci and Gram negative bacilli was 42.65% (119/279) and 35.13% (98/279) respectively.Pseudomonas sp.was the most common pathogen (20.07%).Resistance of the cultured bacteria was 20.2% to ofloxacin,35.9% to ciprofloxacin,15.5% to levofloxacin and 29.4% to tobramycin.Significant resistance ability was revealed in Staphycoccus sp.to ciproloxacin and streptococcus sp.to tobramycin.The Gram negative bacilli showed a stronger resistance to ciproloxacin than to ofloxacin and levofloxacin (χ2=7.486,11.932;P<0.01).The resistance of isolates in the elder people(≥60years) to ciprofloxacin,levofloxacin and tobramycin was stronger than that in the other age(>14 to 59y) (χ2=14.744,5.835,19.709;P<0.05).ConclusionPseudomonas sp.and Staphycoccus sp.are the most common pathogens of bacterial keretitis.The increased fluoroquinolones resistance of these pathogens presents an important therapeutic challenge for bacterial keretitis.

【关键词】 角膜炎细菌药物耐受病原学
【Key words】 keretitisbacteriumdrug resistanceetiology
  • 【文献出处】 眼科研究 ,Chinese Ophthalmic Research , 编辑部邮箱 ,2007年04期
  • 【分类号】R772.21
  • 【被引频次】44
  • 【下载频次】424
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