眼部感染病原菌对氨基糖苷类抗菌药物的耐药性研究  

Clinical analysis of resistance of pathogens of eye infections to aminoglycoside antibiotic therapy

作　　者：郭晓文[1] 吴坤林[1] 姜蕾[1] 

机构地区：[1]杭州市余杭区第一人民医院眼科,浙江杭州311100

出　　处：《中华医院感染学杂志》2015年第14期3210-3212,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅重点扶持基金资助项目(ZW-2012B-031)

摘　　要：目的对眼部感染的病原菌分布及其对氨基糖苷类抗菌药物的耐药性进行分析,为临床合理选择用抗菌药物提供参考。方法对2010年3月-2012年12月220例眼部感染患者感染病原菌进行分离、培养、鉴定和药敏试验,分析培养的阳性率、病原菌分布及其对氨基糖苷类抗菌药物的耐药性,应用SPSS15.0软件进行数据统计分析。结果 220例眼部感染患者送检标本中培养出病原菌168株,检出阳性率为76.36%;其中真菌17株占10.12%、革兰阳性菌89株占52.98%、革兰阴性菌62株占36.90%,革兰阳性菌显著高于革兰阴性菌和真菌(P<0.05);表皮葡萄球菌、金黄色葡萄球菌,对妥布霉素敏感率,分别为53.85%、100.00%,流感嗜血杆菌、铜绿假单胞杆菌、大肠埃希菌对妥布霉素的敏感率,分别为86.96%、100.00%、88.24%。结论眼部感染的致病菌以革兰阳性菌为主,在所选氨基糖苷类抗菌药物中,妥布霉素抗菌活性最强,庆大霉素抗菌活性最弱,临床应根据药敏结果合理选择使用氨基糖苷类抗菌药物,尽可能避免耐药菌的产生。OBJECTIVE To analyze the distribution and drug resistance of pathogens of eye infections to aminoglycoside antibiotic therapy,so as to provide reference for clinical rational choice of drugs.METHODS Pathogens in220 cases of eye infections during Mar.2010 to Dec.2012 were isolated,cultured,identified and tested by susceptibility testing to analyze the culture-positive rate,species distribution and resistance to commonly used antimicrobial aminoglycosides.RESULTS Totally 168 pathogenic strains were cultured from the 220 cases,the positive rate was 76.36%,including 17 fungi accounting for 10.12%,and 89gram-positive strains accounting for 52.98% and62gram-negative strains accounting for 36.90%,indicating that the count of gram-positive bacteria were significantly higher than that of gram-negative bacteria and fungi（P〈0.05）.The resistances of Staphylococcus epidermidis,Staphylococcus aureus,Haemophilus influenza,Pseudomonas aeruginosa and Escherichia coli to tobramycin were 53.58%,100.00%,86.96%,100.00%,and 88.24%,respectively.CONCLUSIONPathogens of eye infections are mainly gram-positive bacteria.Among the selected aminoglycoside antibiotic drugs,tobramycin has the strongest antimicrobial activity and gentamicin the weakest.The clinical use of aminoglycosides should be a reasonable choice based on susceptibility results,so as to avoid the generation of resistant bacteria as far as possible.

关 键 词：氨基糖苷类 抗菌药物 眼部 病原菌 

分 类 号：R978.1[医药卫生—药品]