青光眼患者常用大剂量滴眼液微生物污染情况的临床研究  

The microbial contamination of commonly used multi-dose eye drops in glaucoma patients

作　　者：王英明[1] 殷雪[1] 任亚璐[2] 张晓峰[1,3] Yingming Wang;Xue Yin;Yalu Ren;Xiaofeng Zhang(Department of Ophthalmology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Center of Clinical Laboratory,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Ophthalmology,Dushu Lake Hospital Affiliated to Soochow University,Suzhou 215123,China)

机构地区：[1]苏州大学附属第一医院眼科,215006 [2]苏州大学附属第一医院临床检测中心,215006 [3]苏州大学附属独墅湖医院眼科,215123

出　　处：《中华眼科医学杂志（电子版）》2021年第6期359-364,共6页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：国家自然科学青年基金项目(8210060400);江苏省自然科学基金项目(BK20210095)。

摘　　要：目的探讨青光眼患者常用大剂量滴眼液的微生物污染情况和微生物种类。方法收集2019年5月至2020年4月于苏州大学附属第一医院眼科门诊就诊的青光眼患者所使用的250支滴眼液瓶。其中,抗青光眼滴眼液212支,抗生素滴眼液9支,抗生素类固醇滴眼液15支,非甾体抗炎滴眼液和散瞳滴眼液各7支。分别采集滴眼液滴头和瓶内残留滴眼液的微生物标本,并进行微生物培养,鉴定微生物的种类。滴眼液瓶的种类、污染的瓶数及阳性污染菌的株数采用频数表示。滴眼液瓶阳性污染菌的构成和滴眼液的污染率采用株数和百分比表示,组间比较采用卡方检验或Fisher精确检验。结果250支滴眼液中检出有微生物污染16支,占6.4%。滴头和瓶内残留滴眼液检出污染滴眼液分别为14支和2支,分别占5.6%和0.8%。经卡方检验,两者比较的差异有统计学意义(χ^(2)=9.298,P<0.05)。抗青光眼滴眼液和非抗青光眼滴眼液分别检出污染滴眼液14支和2支,分别占6.6%和5.3%。经卡方检验,两者比较的差异无统计学意义(χ^(2)=3.619,P>0.05)。抗生素滴眼液和非抗生素滴眼液检出污染滴眼液分别为0支和16支,分别占0和7.0%。经Fisher精确检验,两者比较的差异有统计学意义(P<0.05)。污染微生物中,共检测出细菌菌株16株,真菌菌株2株。以表皮葡萄球菌、大肠埃希菌及棒状杆菌属居多,分别为3株、3株及2株,分别占16.7%、16.7%及11.1%。结论滴头微生物污染检出率高于瓶内残留滴眼液,非抗生素类滴眼液微生物污染检出率高于抗生素。污染微生物以表皮葡萄球菌、大肠埃希菌及棒状杆菌属等环境常见菌株,青光眼患者的大剂量滴眼液易受到微生物污染,滴眼液的用药安全需引起重视。Objective The aim of this study was to investigate the microbial contamination and microbial species of ophthalmic multi-dose eye drops in glaucoma patients.Methods 250 eye drops used by glaucoma patients in the Ophthalmology Clinic of the First Affiliated Hospital of Soochow University from May 2019 to April 2020 were collected.Among them,there were 212 anti-glaucoma eye drops,9 antibiotic eye drops,15 antibiotic steroid eye drops,7 non-steroidal anti-inflammatory eye drops and 7 mydriasis eye drops.The dropper tip and the residual eye drops in the bottle were collected and cultured respectively,and then microbial species were identified.The type of eyedrop bottle,the number of contaminated cases and the number of positive contaminated bacteria were expressed as frequency.The composition of eye drop bottles and positive contaminating bacteria and the contamination rate of eye drops were expressed as the number of cases and percentage.Chi-square test or Fisher′s exact test were used for comparison between groups.Results 16 of 250 eye drops were contaminated,accounting for 6.4%.14 and 2 contaminated eye drops were detected in the dripper tip group and the residual eye drops group,accounting for 5.6%and 0.8%,respectively.Chi-square test showed that there was statistically significant difference between two groups(χ^(2)=9.298,P<0.05).14 and 2 contaminated eye drops were detected in anti-glaucoma eye drops group and non-anti-glaucoma eye drops group,accounting for 6.6%and 5.3%,respectively.Chi-square test showed that there was no significant difference between two groups(χ^(2)=3.619,P>0.05).None and 16 contaminated eye drops were detected in antibiotic eye drops group and non antibiotic eye drops group,accounting for 0 and 7.0%,respectively.Fisher′s exact test showed that there were statistically significant difference between two groups(P<0.05).The contaminated microorganisms were composed of 16 bacterial strains and 2 fungal strains.3 strains of Staphylococcus epidermidis accounting for 16.7%,3 strains of Esc

关 键 词：青光眼 大剂量 滴眼液 微生物污染 

分 类 号：R775[医药卫生—眼科]