■本研究的目的是调查流行病学特征,分离株的分布,流行的模式,中国西南地区某三级转诊医院细菌性角膜炎(BK)的抗生素敏感性。
■对2015年1月至2022年12月之间发生的660例细菌性角膜炎进行了回顾性分析。人口统计数据,诱发因素,微生物的发现,和抗生素敏感性谱进行了检查。
■角膜创伤成为最普遍的诱发因素,占病例的37.1%。在这些案例中,318例细菌培养结果为阳性,鉴定出细菌68种。最常见的革兰氏阳性菌是表皮葡萄球菌,最常见的革兰氏阴性菌是铜绿假单胞菌。耐甲氧西林葡萄球菌占所有革兰氏阳性菌的18.1%。铜绿假单胞菌检出率随时间呈增加趋势(Rs=0.738,P=0.037)。随着时间的推移,革兰氏阴性微生物的百分比显着降低(Rs=0.743,P=0.035)。革兰阳性菌对利奈唑胺的敏感性,万古霉素,替加环素,quinupristin/dalfopristin,利福平超过98%。革兰阴性菌对阿米卡星的敏感率,美罗培南,哌拉西林/他唑巴坦,头孢哌酮钠/舒巴坦,头孢他啶,头孢吡肟和头孢吡肟均在85%以上。有植物人创伤史的病人,除了关注真菌性角膜炎外,还应考虑BK的可能性。
微生物组成主要由革兰氏阳性球菌和革兰氏阴性杆菌组成。在革兰氏阳性菌中,表皮葡萄球菌和肺炎链球菌是最常见的,而铜绿假单胞菌是主要的革兰氏阴性细菌。为了对抗革兰氏阳性菌,万古霉素,利奈唑胺,和利福平被认为是优异的抗微生物剂。当靶向革兰氏阴性病原体时,与第一代和第二代头孢菌素相比,第三代头孢菌素具有更高的敏感性.作为社区环境中细菌性角膜炎和对第四代氟喹诺酮类药物无反应的严重病例的初始经验治疗,万古霉素和妥布霉素的联合治疗是合理的方法。通过了解局部病因和抗菌药物敏感性模式,可以更好地控制细菌性角膜炎。
UNASSIGNED: The objective of this study was to investigate the epidemiological characteristics, distribution of isolates, prevailing patterns, and antibiotic susceptibility of bacterial keratitis (BK) in a Tertiary Referral Hospital located in Southwest China.
UNASSIGNED: A retrospective analysis was conducted on 660 cases of bacterial keratitis occurring between January 2015 and December 2022. The demographic data, predisposing factors, microbial findings, and antibiotic sensitivity profiles were examined.
UNASSIGNED: Corneal trauma emerged as the most prevalent predisposing factor, accounting for 37.1% of cases. Among these cases, bacterial culture results were positive in 318 cases, 68 species of bacteria were identified. The most common Gram-Positive bacteria isolated overall was the staphylococcus epidermis and the most common Gram-Negative bacteria isolated was Pseudomonas aeruginosa. Methicillin-Resistant Staphylococci accounted for 18.1% of all Gram-Positive bacteria. The detection rate of P. aeruginosa showed an increasing trend over time (Rs=0.738, P=0.037). There was a significant decrease in the percentage of Gram-Negative microorganisms over time (Rs=0.743, P=0.035). The sensitivity of Gram-Positive bacteria to linezolid, vancomycin, tigecycline, quinupristin/dalfopristin, and rifampicin was over 98%. The sensitivity rates of Gram-Negative bacteria to amikacin, meropenem, piperacillin/tazobactam, cefoperazone sodium/sulbactam, ceftazidime, and cefepime were all above 85%. In patients with a history of vegetative trauma, the possibility of BK should be taken into account in addition to the focus on fungal keratitis.
UNASSIGNED: The microbial composition primarily consists of Gram-Positive cocci and Gram-Negative bacilli. Among the Gram-Positive bacteria, S. epidermidis and Streptococcus pneumoniae are the most frequently encountered, while P. aeruginosa is the predominant Gram-Negative bacteria. To combat Gram-Positive bacteria, vancomycin, linezolid, and rifampicin are considered excellent antimicrobial agents. When targeting Gram-Negative pathogens, third-generation cephalosporins exhibit superior sensitivity compared to first and second-generation counterparts. As an initial empirical treatment for severe cases of bacterial keratitis and those unresponsive to fourth-generation fluoroquinolones in community settings, the combination therapy of vancomycin and tobramycin is a justifiable approach. Bacterial keratitis can be better managed by understanding the local etiology and antibacterial drug susceptibility patterns.