化脓性眼内炎患者的病因与致病菌研究  

Etiology and pathogens of suppurative endophthalmitis

作　　者：牛立伟 郭光[2] NIU Li-wei;GUO Guang(Linzhou Hospital of taditional Chinese medicine ophthalmology,Anyang Henan 456550,China;Anyang Eye Hospital,Anyang Henan 45500,China)

机构地区：[1]林州市中医院眼科,河南安阳456550 [2]安阳市眼科医院眼科,河南安阳455000

出　　处：《实用防盲技术》2024年第2期67-70,52,共5页Journal of Practical Preventing Blind

摘　　要：目的探究化脓性眼内炎患者的病因及致病菌特征。方法选取2016年1月至2018年12月在我院进行诊疗的化脓性眼内炎患者82例82只眼,搜集其既往病史信息,分析病因。在无菌环境中收集病眼的眼内液标本,培养细菌、真菌,并开展药敏试验。记录阳性病原菌菌谱,分析药敏试验结果。结果61%的化脓性眼内炎患眼是由外伤引起的,18.3%是因内眼手术引起的,17.1%是因化脓性角膜炎引起的,3.7%化脓性眼内炎属于内源性眼内炎。细菌菌株占71.4%,包括G+菌54.3%、G-菌17.1%。真菌菌株共10株,曲霉类5株,镰刀类3株,2株为其他类真菌。G+菌对氧氟沙星、夫地西酸、加替沙星、万古霉素的敏感性分别为65.5%、78.1%、92.4%、96.4%。G-菌对加替沙星、左氧氟沙星、妥布霉素敏感性分别为86.3%、78.5%、77.9%。真菌总敏感性最高的是伏立康唑为88.5%,其次是两性霉素B敏感性为86.3%,其他药物敏感性较低。结论化脓性眼内炎的病因主要是外伤,内眼手术、化脓性角膜炎是常见病因。革兰氏阳性致病菌占比最高;其次为真菌类致病菌,主要是曲霉菌和镰刀菌。Objective To investigate the etiology and pathogenic characteristics of suppurative endophthalmitis.Methods82 cases(82 eyes)of suppurative endophthalmitis were selected from January 2016 to December 2018 in our hospital.The information of past medical history was collected and the etiology was analyzed.The specimens of diseased eyes in sterile environment were collected,the bacteria and fungi were cultivated,and drug susceptibility test was carried out.The spectrum of positive pathogenic bacteria was recorded and the drug sensitivity test results were analyzed.Results 61%of eyes with purulent endophthalmitis are caused by trauma,18.3%are caused by internal eye surgery,17.1%are caused by purulent keratitis,and 3.7%of purulent endophthalmitis are endogenous intraocular inflammation.Bacterial strains accounted for 71.4%,including 54.3%of G+bacteria and 17.1%of G-bacteria.There were 10 strains of fungi,5 strains of Aspergillus,3 strains of Fusarium and 2 strains of other fungi.The sensitivity of G+bacteria to ofloxacin,fudicinic acid,gatifloxacin and vancomycin were 65.5%,78.1%,92.4%and 96.4%,respectively.The sensitivity of G-bacteria to gatifloxacin,levofloxacin and tobramycin were 86.3%,78.5%and 77.9%,respectively.The highest total fungal susceptibility was voriconazole(88.5%),followed by amphotericin B(86.3%),and other drugs were less susceptible.Conclusion Trauma is the main cause of suppurative endophthalmitis.Internal eye surgery and suppurative keratitis are common causes.Gram-positive pathogens accounted for the highest proportion,followed by fungal pathogens,mainly Aspergillus and Fusarium.

关 键 词：化脓性眼内炎 病因 致病菌 药物敏感性试验 

分 类 号：R77[医药卫生—眼科]