青少年配戴角膜塑形镜后结膜囊菌群状况及药敏分析  

Analysis of conjunctival sac microflora and antibiotic susceptibility testing in adolescents after wearing orthokeratology lens

作　　者：王若馨 张学辉[1] 李盼 王瑾[1] 黎彦宏[1] 艾欣 白岩峰 Ruo-Xin Wang;Xue-Hui Zhang;Pan Li;Jin Wang;Yan-Hong Li;Xin Ai;Yan-Feng Bai(Department of Ophthalmology,Xi'an No.1 Hospital,Shaanxi Institute of Ophthalmology,Shaanxi Key Laboratory of Ophthalmology,Clinical Research Center for Ophthalmology Disease of Shaanxi Province,Xi'an 710002,Shaanxi Province,China)

机构地区：[1]中国陕西省西安市第一医院眼科、陕西省眼科研究所、陕西省眼科学重点实验室、陕西省眼科疾病临床医学研究中心,710002

出　　处：《国际眼科杂志》2023年第9期1589-1593,共5页International Eye Science

基　　金：西安市卫生健康委员会一般研究项目(No.2021yb36)。

摘　　要：目的:研究青少年配戴角膜塑形镜后结膜囊细菌菌群状况及药物敏感性分析。方法:观察性横断面研究。招募2021-09/2022-08在西安市第一医院门诊就诊的8~14岁青少年患者101例,其中配戴角膜塑形镜组51例及配戴框架眼镜组50例,均取右眼入组。比较两组患者结膜囊细菌培养情况,采用基质辅助激光解吸/电离飞行时间质谱仪鉴定种类,对配戴角膜塑形镜组培养阳性菌株进行药物敏感性实验。结果:配戴角膜塑形镜组患者结膜囊细菌培养阳性率为68.6%(35/51),配戴框架眼镜组培养阳性率为60.0%(30/50)(P>0.05),两组检出率最高的菌种均为表皮葡萄球菌和金黄色葡萄球菌。配戴角膜塑形镜组检出菌株对药物的敏感率为:左氧氟沙星(98%)、莫西沙星(98%)、加替沙星(98%)、头孢呋辛(98%)、头孢硫脒(98%)、利福平(98%)、氯霉素(96%)、头孢西丁(95%)、克林霉素(80%)、庆大霉素(74%)、夫西地酸(72%)、妥布霉素(64%)、复方新诺明(26%)、美洛西林(10%)、阿奇霉素(6%),其中革兰氏阳性球菌对万古霉素敏感率为100%。结论:青少年配戴角膜塑形镜后结膜囊主要分离菌属为革兰氏阳性球菌,戴镜不会明显提高其结膜囊细菌阳性率。药敏结果对戴镜者发生眼部感染后的经验性用药可能有指导意义。AIM:To investigate the bacterial flora and antibiotic susceptibility testing of conjunctival sac in adolescents after wearing orthokeratology(OK)lens.METHODS:A total of 101 adolescents aged 8 to 14 who admitted to outpatient department of Xi’an No.1 Hospital from September 2021 to August 2022 were recruited in this cross-sectional observational study.There were 51 cases wearing OK Lens(wearing group)and 50 patients not wearing contact lens(non-lens group),the right eye of all patients was selected into the group.The culture of bacterial flora in conjunctival sac between the two groups were compared,the species were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry,and the antibiotic susceptibility testing was carried out for the positive strains cultured in the wearing group.RESULTS:The positive rate of conjunctival sac bacterial cultured in the wearing group and the non-lens group was 68.6%(35/51)and 60.0%(30/50),respectively(P>0.05).In both groups,the bacteria with the highest detection rate were staphylococcus epidermidis and staphylococcus aureus.The sensitivity rates of the strains detected in the wearing group to drugs are as follows:Levofloxacin(98%),Moxifloxacin(98%),Gatifloxacin(98%),Cefuroxime(98%),Cefathiamidine(98%),Rifampicin(98%),Chloramphenicol(96%),Cefoxitin(95%),Clindamycin(80%),Gentamicin(74%),Fusidic acid(72%),Tobramycin(64%),Compound sulfamethoxazole(26%),Mezlocillin(10%),Azithromycin(6%),of which the sensitivity rate of Gram-positive cocci was 100%sensitive to Vancomycin.CONCLUSION:Gram-positive cocci are the main bacteria isolated from conjunctival sac of adolescents after wearing OK Lens.Wearing OK Lens will not significantly increase the positive rate of conjunctival sac bacterial flora.Results of antibiotic susceptibility testing may provide guidance for empirical medication in patients wearing OK lens after eye infection.

关 键 词：角膜塑形镜 结膜囊菌群 抗生素药敏实验 

分 类 号：R778.11[医药卫生—眼科]