慢性泪囊炎微生物分布及其耐药性  

Microbial distribution and drug resistance in chronic dacryocystitis

作　　者：陈宇 赵雅[2] 王林[2] CHEN Yu;ZHAO Ya;WANG Lin(Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China;Department of Clinical Laboratory,Xi'an First Hospital,Xi'an 710002,Shaanxi,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：《检验医学》2024年第3期256-259,共4页Laboratory Medicine

摘　　要：目的了解慢性泪囊炎微生物分布及其耐药性,为临床经验性用药提供参考。方法收集2022年6月—2023年6月西安市第一医院104例慢性泪囊炎患者泪囊分泌物样本。采用自动化微生物鉴定药敏仪进行菌株鉴定。分别采用仪器法和纸片扩散法进行体外药物敏感性试验,分析2种方法的一致性。结果慢性泪囊炎患者细菌培养阳性率为74.04%(77/104),共分离出109株细菌,其中革兰阳性菌75株(68.81%)、革兰阴性菌23株(21.10%)、厌氧菌10株(9.17%)、真菌1株(0.92%)。葡萄球菌对莫西沙星、利福平和万古霉素的敏感率分别为80.00%、97.50%和100.00%。耐甲氧西林葡萄球菌(MRS)对抗菌药物的耐药率明显高于甲氧西林敏感葡萄球菌(MSS);MRS和MSS对左氧氟沙星和克林霉素的耐药率差异有统计学意义(P<0.05)。仪器法与纸片扩散法药物敏感性试验一致性较好(Kappa值为0.832,P<0.05)。结论葡萄球菌是慢性泪囊炎的主要致病菌,莫西沙星、利福平和万古霉素可作为治疗慢性泪囊炎的首选抗菌药物。Objective To investigate the microbial distribution and drug resistance in chronic dacryocystitis,and to provide a reference for empirical clinical use.Methods A total of 104 patients with chronic dacryocystitis were enrolled from Xi'an First Hospital from June 2022 to June 2023,and the specimens of dacryocystic secretions were collected for identification by automated identification drug sensitivity instrument.In vitro drug susceptibility test was carried out by instrument method and disk diffusion method,and the consistency of the 2 methods was analyzed.Results The bacterial positive determination rate in patients with chronic dacryocystitis was 74.04%(77/104),with a total of 109 strains isolated,among them,75 cases of Gram-positive(68.81%),23 cases of Gramnegative(21.10%),10 cases of anaerobic bacteria(9.17%)and 1 case of fungus(0.92%).The most sensitive antimicrobial drugs against Staphylococcus were moxifloxacin,rifampicin and vancomycin,with sensitivity rates of 80.00%,97.50%and 100.00%,respectively.The drug resistance rate of methicillin-resistant Staphylococcus(MRS)was higher than that of methicillin-sensitive Staphylococcus(MSS),and there was statistical significance for levofloxacin and clindamycin(P<0.05).The consistency of drug susceptibility test between instrument method and disk diffusion method was good(Kappa value was 0.832,P<0.05).Conclusions Staphylococcus is the main pathogen of chronic dacryocystitis,and moxifloxacin,rifampicin and vancomycin can be the drugs of choice for the treatment of chronic dacryocystitis.

关 键 词：慢性泪囊炎 葡萄球菌 耐甲氧西林葡萄球菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]