定期评估细菌污染是必要的,因为它可以通过使用适当的抗生素在眼部感染的情况下提供适当的指导。由于抗生素治疗的广泛使用,引起感染的许多微生物群菌株对通常的眼科抗生素具有抗性。本研究提供了对白内障手术患者眼表发现的革兰氏阳性和革兰氏阴性细菌对最常用抗生素的敏感性的最新评估。共有993名患者被纳入研究,年龄在44至98岁之间。在白内障手术前7天收集结膜培养物。革兰氏阳性和革兰氏阴性细菌对各种抗生素类别的反应,如糖肽,头孢菌素,碳青霉烯类,氟喹诺酮类药物,氨基糖苷类,酚类化合物,四环素,利福霉素,大环内酯类和青霉素类,被评估。从测试的抗生素中,万古霉素对革兰氏阳性菌的疗效为97.8%。在头孢菌素类别中,我们观察到头孢呋辛对革兰氏阳性菌和阴性菌均有较高的耐药性.对革兰氏阳性菌有90%以上疗效的抗生素是美罗培南,亚胺培南,奈替米星,阿米卡星和利福平.在革兰氏阴性细菌上,我们发现所有测试的氟喹诺酮类药物100%有效,即,氨基糖苷类(妥布霉素除外),多西环素,阿奇霉素,克拉霉素和氯霉素。当前的研究说明了眼表上存在的某些细菌对眼科临床实践中一些常用抗生素的耐药性增加的模式。头孢呋辛就是这样一个明显的例子,已被高度用作预防白内障手术后细菌性眼内炎的前房内抗生素。
Periodic assessment of bacterial contamination is necessary as it allows proper guidance in cases of eye infections through the use of appropriate antibiotics. Due to the extensive use of antibiotic treatment, many strains of the microbiota that cause infections are resistant to the usual ophthalmic antibiotics. The present study provides an updated assessment of the susceptibility of Gram-positive and Gram-negative bacteria found on the ocular surface to the most commonly used antibiotic agents in patients undergoing cataract surgery. A total of 993 patients were included in the study with ages between 44 and 98 years old. Conjunctival cultures were collected 7 days before cataract surgery. The response of Gram-positive and Gram-negative bacteria to various antibiotic classes, such as glycopeptides, cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, phenicols, tetracyclines, rifamycins, macrolides and penicillins, was assessed. From the tested antibiotics, vancomycin had 97.8% efficacy on Gram-positive bacteria. In the cephalosporin category, we observed a high level of resistance of the cefuroxime for both Gram-positive and negative bacteria. Antibiotics that have more than 90% efficacy on Gram-positive bacteria are meropenem, imipenem, netilmicin, amikacin and rifampicin. On Gram-negative bacteria, we found 100% efficacy of all tested fluoroquinolones, i.e., aminoglycosides (except for tobramycin), doxycycline, azithromycin, clarithromycin and chloramphenicol. The current study illustrates patterns of increased resistance in certain bacteria present on the ocular surface to some of the commonly used antibiotics in ophthalmological clinical practice. One such revealing example is cefuroxime, which has been highly used as an intracameral antibiotic for the prevention of bacterial endophthalmitis after cataract surgery.