化脓性眼内炎细菌培养结果分析  

Suppurative endophthalmitis bacterial culture

作　　者：王斌 

机构地区：[1]达州中西医结合医院眼科,四川达州635000

出　　处：《热带医学杂志》2016年第4期471-473,共3页Journal of Tropical Medicine

摘　　要：目的分析化脓性眼内炎细菌培养的临床特征以及对药物的敏感度,为临床治疗化脓性眼内炎选择适合的抗菌药物提供科学依据。方法选取132例化脓性眼内炎患者,患者均行玻璃体切除术或玻璃体腔内注射药物,并于术前取玻璃体液作为样本进行细菌与真菌培养,分析培养的阳性菌株以及对药物敏感度的结果。结果 132例样本中,有70例样本培养出阳性菌株,阳性菌检出率为53.03%。70例阳性菌株中,有37例为革兰阳性菌,其中表皮葡萄球菌11例、铜绿假单胞菌9例、肠杆菌6例、变形杆菌5例、产碱杆菌3例、肺炎克雷伯菌3例,所占革兰阳性菌百分比分别为29.73%、24.32%、16.22%、13.51%、8.11%、8.11%。行药敏试验发现,环丙沙星、头孢哌酮、头孢唑啉以及妥布霉素对革兰阳性菌具有较高的敏感度（χ^2值分别为5.632、5.342、5.216、5.106,P〈0.05）,庆大霉素、新霉素、氯霉素等抗生素对革兰阳性菌的敏感度较低（P〉0.05）。结论对化脓性眼内炎患者的玻璃体液进行细菌培养,能观察到患者的致病菌种类,且通过药敏试验能得出药物对患者致病菌的敏感情况,具有重要的现实意义。Objective To analyze the clinical characteristics and drug sensitivity of suppurative endophthalmitis bacterial culture and provide a scientific basis for antibiotic application. Methods 132 suppurative endophthalmitis diagnosed patients underwent vitrectomy or intravitreal injection were selected in January 2012-December 2014. Vitreous humor was collected from the patient before surgery for bacterial and fungal culture; drug sensitivity of the cultures were tested.Results In 132 cases, 70 cases were suppurative endophthalmitis bacterial culture positive, with a detection rate of53.03%. Among the 70 positive cases, 37 cases were Gram-positive bacteria, including 11 cases of Staphylococcus epidermidis,9 cases of Pseudomonas aeruginosa, 6 cases of E. coli, 5 cases of Proteus, 3 cases of Alcaligenes, and 3 cases of Klebsiella pneumoniae, with the percentage of 29.73%, 24.32%, 16.22%, 13.51%, 8.11%, and 8.11%, respectively. The cultured Gram positive strains were more sensitive to ciprofloxacin, cefoperazone, cefazolin and tobramycin（χ~2values were 5.632,5.342, 5.216, and 5.106, respectively, P〈0.05）, and less sensitive to gentamicin, neomycin, chloramphenicol and other antibiotics against Gram-positive bacteria（P〈0.05）. Conclusion Bacteria culture from vitreous humor suppurative endophthalmitis patients could identify the pathogenic bacteria and determine the drug sensitive, and provide better treatment by using appropriate antibiotics.

关 键 词：化脓性眼内炎 细菌培养 药敏试验 

分 类 号：R776.4[医药卫生—眼科] R378[医药卫生—临床医学]