目的:了解苏州地区眼部感染的细菌类型及其对常用抗菌药物的耐药性。
方法:回顾性收集155例患者的临床资料,并对病原菌种类及各病原菌的耐药性进行分析。
结果:在155名患者中(年龄从12岁到87岁,平均年龄为57,99男性和56女性)患有眼部感染(160眼:左眼74,右眼为76,双眼为5,所有这些都是外生的),革兰氏阳性菌71株(45.81%),革兰氏阴性菌23株(14.84%),真菌61株(39.35%)。革兰阳性菌对青霉素和红霉素耐药率较高(分别为78.87%和46.48%),但对万古霉素的耐药性在0。革兰阴性菌对头孢西丁和复方磺胺甲恶唑的耐药率较高(分别为100%和95.65%),但对美罗培南的抗性在0。革兰阳性菌和革兰阴性菌对某些药物的耐药性比较,发现两者对头孢西丁的耐药性差异有统计学意义(P<0.05)。复方新诺明,左氧氟沙星,头孢呋辛,头孢曲松和头孢他啶,两者对革兰氏阴性菌的耐药率都高于对革兰氏阳性菌的耐药率。细菌感染菌株的分布表明表皮葡萄球菌是结膜中最常见的菌株,角膜,房水或玻璃体和其他眼睛部位。此外,镰刀菌和铜绿假单胞菌也是最常见的结膜和角膜感染菌株。
结论:革兰阳性菌是眼部感染的优势菌,其次是革兰氏阴性细菌和真菌。考虑到革兰氏阴性菌对多种药物的耐药性,加强眼部细菌感染的细菌监测,有效预防和控制,减少眼部感染引起的并发症。
OBJECTIVE: To investigate the types of bacteria in patients with eye infections in Suzhou and their drug resistance to commonly used antibacterial drugs.
METHODS: The clinical data of 155 patients were retrospectively collected in this study, and the pathogenic bacteria species and drug resistance of each pathogenic bacteria were analyzed.
RESULTS: Among the 155 patients (age from 12 to 87 years old, with an average age of 57, 99 males and 56 females) with eye infections (160 eyes: 74 in the left eye, 76 in the right eye and 5 in both eyes, all of which were exogenous), 71 (45.81%) strains were gram-positive bacteria, 23 (14.84%) strains were gram-negative bacteria and 61 (39.35%) strains were fungi. Gram-positive bacteria were highly resistant to penicillin and erythromycin (78.87% and 46.48% respectively), but least resistant to vancomycin at 0. Gram-negative bacteria were highly resistant to cefoxitin and compound sulfamethoxazole (100% and 95.65% respectively), but least resistant to meropenem at 0. Comparison of the resistance of gram-positive and gram-negative bacteria to some drugs revealed statistically significant differences (P<0.05) in the resistance of both to cefoxitin, cotrimoxazole, levofloxacin, cefuroxime, ceftriaxone and ceftazidime, and both had higher rates of resistance to gram-negative bacteria than to gram-positive bacteria. The distribution of bacterial infection strains showed that Staphylococcus epidermidis was the most common strain in the conjunctiva, cornea, aqueous humor or vitreous body and other eye parts. Besides, Fusarium and Pseudomonas aeruginosa were also among the most common strains of conjunctival and corneal infections.
CONCLUSIONS: Gram-positive bacteria are the dominant bacteria in eye infections, followed by gram-negative bacteria and fungi. Considering the resistance of gram-negative bacteria to multiple drugs, monitoring of bacteria should be strengthened in eye bacterial infections for effective prevention and control to reduce complications caused by eye infections.