急性细菌性结膜炎致病菌和药物敏感性分析  

Pathogens and their antibiotic sensitivity in acute bacterial conjunctivitis

作　　者：陈晓莲[1] 刘杏[1] 钟兴武[1] 梁洪光[1] 蔡志伟[1] 梁志光[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2005年第3期319-322,共4页Chinese Journal of Practical Ophthalmology

基　　金：广东省科技计划项目 ( 2 0 0 3C32 70 7)

摘　　要：目的　探讨急性细菌性结膜炎致病菌的种类及其对临床常用抗菌素的敏感性。方法　对 2 0 0例 ( 2 0 0只眼 )急性细菌性结膜炎患者结膜囊分泌物进行细菌学检查 ,并对致病菌种类和药物敏感试验结果进行分析。结果　急性细菌性结膜炎结膜囊分泌物涂片革兰氏染色细菌检出率较低( 7 0 0 % ) ,而细菌培养阳性率比较高 ( 1 4 6只眼 ,73. 0 0 % ) ;其中革兰氏阳性细菌有 1 2 9只眼( 88 .36 % ) ,以表皮葡萄球菌、腐生葡萄球菌和金黄色葡萄球菌多见 ,革兰氏阴性细菌 1 7只眼( 1 1 .0 4 % ) ,以大肠埃希氏菌、淋球菌、肺炎克雷伯氏菌和普通变形杆菌多见。大多数主要致病菌对环丙沙星、氧氟沙星等敏感 ,而对氯霉素和利福平耐药。结论　表皮葡萄球菌等条件致病菌已成为急性结膜炎的主要致病菌 ,在临床工作中应有针对性选择有效抗菌素进行治疗 ;尽早获取结膜囊分泌物标本进行细菌培养和药物敏感试验对于病原学诊断和选择敏感抗菌素治疗有重要的临床意义。Objective To investigate the changes of bacterial spectrum and sensitive antibiotics in acute bacterial conjunctivitis.Methods Secretion specimens were taken from the inferior conjunctival surface of 200 eyes of 200 patients with acute bacterial conjunctivitis.Then Gram′s stain and bacterial culture combined with drug sensitivity test were done.Results Secretion specimens were stained with Gram′s stain,bacterial positive rate was only 7 00%,but 146 eyes(73 00%)had culture-positive.129 eyes(88 36%)show Gram′s stain positive bacterium.Most of them were Staphylococcus epidermidais,Staphylococcus saprophyticus,and Staphylococcus aureus.17 eyes(11 04%)show Gram′s stain negative bacterium.Most of them were Escherichia Coli、Neisseria gonorrhoeae、Klebsierlla penmoniae and Proteus Vulgaris.Ciprofloxacin and ofloxacin were the sensitive antibiotics.Most bacteria were resistant to Chloromycetin and Rifampicin.Conclusions The most prevalent bacteria were Staphylococcus epidermidais followed by Escherichia Coli and Staphylococcus saprophyticus.Bacterial culture combined with drug sensitivity test is important in guiding the treatment for acute conjunctivitis.

关 键 词：急性细菌性结膜炎 致病菌 结膜囊 治疗 药物敏感性分析 表皮葡萄球菌 抗菌素 针对性 结论 获取 

分 类 号：R777[医药卫生—眼科] R446[医药卫生—临床医学]