眼表定植菌群分布特征及常见菌耐药性分析  

Distribution characteristics of common bacteria colonizing ocular surface and drug resistance analysis

作　　者：陈宇 赵雅 王林[2] CHEN Yu;ZHAO Ya;WANG Lin(Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]西安市第一医院检验科,陕西西安710002

出　　处：《陕西医学杂志》2023年第10期1423-1426,共4页Shaanxi Medical Journal

基　　金：陕西省科技厅基金资助项目(2017SF-119)。

摘　　要：目的:探讨眼表定植菌群分布及抗菌药物耐药性,为临床经验性用药提供指导。方法:收集健康体检人群眼结膜囊标本共93例,进行细菌培养、鉴定及体外药物敏感试验,统计、分析细菌的检出和分布及主要革兰阳性球菌的耐药情况。结果:93例健康受试者结膜囊标本经培养,87例为阳性,共分离出168株细菌。凝固酶阴性葡萄球菌对多种抗生素呈现出耐药性,耐甲氧西林凝固酶阴性葡萄球菌(MRCoNS)组对抗生素的耐药率明显高于甲氧西林敏感凝固酶阴性葡萄球菌(MSCoNS)组,其中青霉素、环丙沙星、左氧氟沙星、克林霉素及复方新诺明五种药物耐药性比较差异有统计学意义(均P<0.05),PCR检测mecA基因与VITEK 2 Compact仪器法对MRCoNS苯唑西林耐药性预测的结果符合率是97.5%。结论:G+球菌为眼表的主要定植菌,其中凝固酶阴性葡萄球菌为优势菌,我们应加强对葡萄球菌特别是MRS耐药性的监测,指导临床根据药敏结果合理规范使用抗生素。Objective:To investigate the distribution of bacterial flora colonizing ocular surface and antimicrobial resistance,and to provide guidance for clinical empirical drug use.Methods:A total of 93 eye conjunctival capsule specimens were collected from healthy people who underwent physical examination.Bacterial culture,identification and in vitro drug sensitivity test were conducted.The detection and distribution of bacteria and drug resistance of main gram-positive cocci were analyzed statistically.Results:In 93 healthy subjects,87 cases were positive and 168 strains of bacteria were isolated.Coagulase-negative staphylococcus showed resistance to a variety of antibiotics,and the resistance rate of MRCoNS group was significantly higher than that of MSCoNS group,among which the differences of penicillin,ciprofloxacin,levofloxacin,clindamycin and cotrimoxazole were statistically significant(P<0.05).The coincidence rate of mecA detection and VITEK 2 Compact instrument method was 97.5%.Conclusion:Ggram-positive coccus is the main colonizing bacteria of the ocular surface,among which coagulase negative Staphylococcus is the dominant bacteria.We should strengthen the monitoring of drug resistance of Staphylococcus,especially MRS,and guide clinical rational and standardized use of antibiotics according to drug sensitivity results.

关 键 词：眼表菌群 定植 抗生素 耐药性 聚合酶链式反应 耐甲氧西林葡萄球菌 

分 类 号：R378[医药卫生—病原生物学]