PDF(Pubmed)
Abstract：
The objective of this study was to investigate the culture positivity and distribution of the conjunctival sac bacteria in the perioperative period of corneal refractive surgery. The selected time points of the perioperative period included before the use of antibiotic eye drops, before eye wash (after the use of antibiotic eye drops), after eye wash, and immediately after surgery. Conjunctival specimens obtained at the four time points were cultured to detect the positivity and distribution of bacteria. Before prophylactic antibiotic eye drops were administered, 49 eyes (50%) had positive bacterial culture results, with 45 isolates (91.8%) identified as Staphylococcus epidermidis. The culture positivity rates of the conjunctival sac specimens before eye wash, after eye wash, and immediately after surgery were 19.4%, 3.1%, and 4.1%, respectively. The difference was significant before and after the use of antibiotics and before and after eye wash (both P < 0.001). Staphylococcus epidermidis was the major pathogen in the conjunctival sac before corneal refractive surgery, and the culture positivity rate of the conjunctival bacteria was higher in males. Sixteen of 37 eyes (43.2%) with contact lenses had positive culture results, compared to 33 of 61 eyes (54.1%) without contact lenses (P > 0.05). The judicious preoperative use of antibiotic eye drops combined with the surgical sterile eye wash procedure maximised the removal of conjunctival sac bacteria. Skilled surgical manipulations generally did not increase the risk of infection.
摘要：
本研究的目的是调查角膜屈光手术围手术期结膜囊细菌的培养阳性和分布。围手术期的选定时间点包括使用抗生素滴眼液之前，洗眼前（使用抗生素滴眼液后），洗眼后,手术后立即。培养在四个时间点获得的结膜标本以检测细菌的阳性和分布。在给予预防性抗生素滴眼液之前，49眼（50%）细菌培养结果阳性，45株（91.8%）被鉴定为表皮葡萄球菌。洗眼前结膜囊标本的培养阳性率，洗眼后,手术后立即占19.4%，3.1%,和4.1%，分别。抗生素使用前后及洗眼前后差异均有统计学意义(均P<0.001)。表皮葡萄球菌是角膜屈光手术前结膜囊内的主要病原菌,男性结膜细菌培养阳性率较高。37眼(43.2%)接触镜培养结果呈阳性,61只眼睛中有33只（54.1％）没有隐形眼镜（P>0.05）。术前明智使用抗生素滴眼液结合手术无菌洗眼程序可最大程度地去除结膜囊细菌。熟练的手术操作通常不会增加感染的风险。
