519例感染性眼内炎的临床及微生物学特征  

Clinical features and microbiological characteristics of 519 cases of infectious endophthalmitis

作　　者：贾佩佩 曹晓禄 尹会苏 赵莉莉 段羽 李桃 杨赞章 贾军晓 JIA Peipei;CAO Xiaolu;YIN Huisu;ZHAO Lili;DUAN Yu;LI Tao;YANG Zanzhang;JIA Junxiao(Hebei Eye Hospital,Xingtai,Hebei 05400l,China;不详)

机构地区：[1]河北省眼科医院药剂科,河北邢台054001 [2]河北省眼科医院糖尿病眼病科,河北邢台054001 [3]河北省眼科医院科教科,河北邢台054001 [4]秦皇岛市第一医院药剂科,河北秦皇岛066099 [5]河北省眼科医院检验科,河北邢台054001 [6]河北省眼科医院视光学科,河北邢台054001

出　　处：《中华医院感染学杂志》2025年第3期390-394,共5页Chinese Journal of Nosocomiology

基　　金：河北省邢台市科技计划基金项目(2022ZC079、2022ZC234)。

摘　　要：目的分析感染性眼内炎的临床特点及微生物学特征,为眼科临床诊治与用药提供参考。方法统计河北省眼科医院2014—2023年收治的519例感染性眼内炎病例信息,分析近五年(2019—2023年)和前五年(2014—2018),比较两组感染性眼内炎患者的临床特点,包括性别、地区分布、年龄、发病季节、致病原因以及微生物特征。结果感染性眼内炎男性(73.22%)多于女性(26.78%),乡村(96.34%)多于城镇(3.66%),秋季(29.29%)发病最多。首要致病原因是眼外伤(73.60%),其次为眼科手术(21.00%),以白内障手术(63.30%)和青光眼手术(21.10%)后感染例数最多。2014—2018年组和2019—2023年组相比,真菌有增多趋势(P<0.05)。感染性眼内炎的首位检出菌为革兰阳性菌,以表皮葡萄球菌(37.83%)为主,耐甲氧西林表皮葡萄球菌(MRSE)检出率高于甲氧西林敏感表皮葡萄球菌(MSSE),左氧氟沙星耐药率升高(P<0.05)。结论感染性眼内炎的临床特点在近年来有所变化,微生物学特征也有所差异,因此在眼科临床诊断、治疗及用药策略方面,应进行全面评估。OBJECTIVE To analyze the clinical features and microbiological characteristics of infectious endophthalmitis,and to provide reference for the clinical diagnosis,treatment and medication for ophthalmology.METHODS Informations of 519 cases of infectious endophthalmitis admitted to the Hebei Eye Hospital from 2014 to 2023 was statistically analyzed as the early five years group(2019-2023)and the later five years group(2014-2018),and the clinical characteristics in the two groups were also compared,including gender,regional distribution,age,onset season,pathogenic factors and microbial characteristics.RESULTS Infectious endophthalmitis was more common in males(73.22%)than in females(26.78%),more common in rural areas(96.34%)than in urban areas(3.66%),and most common in autumn(29.29%).The leading causative agent was ocular trauma(73.60%),followed by ophthalmic surgery(21.00%)with the highest number of cataract surgery(63.30%)and glaucoma surgery(21.10%).There was a trend of increasing fungi in the 2014-2018 group compared to the 2019-2023 group(P<0.05).The bacteria ranked first in infectious endophthalmitis were gram-positive bacteria,mainly was Staphylococcus epidermidis(37.83%),with a higher detection rate of methicillin-resistant Staphylococcus epidermidis(MRSE)than that of methicillin-sensitive Staphylococcus epidermidis(MSSE),and an elevated rate of levofloxacin resistance(P<0.05).CONCLUSION The clinical characteristics of infectious endophthalmitis have changed in recent years,and the microbiological characteristics have also varied.Therefore,comprehensive and rigorous evaluation should be conducted for clinical diagnosis,treatment and drug strategy of ophthalmology.

关 键 词：感染性眼内炎 变化趋势 微生物学特征 临床表现 

分 类 号：R771.3[医药卫生—眼科]