The effectiveness of topical fusidic acid 1%, in a viscous drop base, to reduce or eliminate ocular microflora in patients undergoing cataract surgery has been studied. Forty-two patients received fusidic acid on a double-blind basis and for comparison 21 patients were similarly assessed with topical chloramphenicol. A further 17 patients received no treatment other than subconjunctival cephazolin administered to all operated eyes at the time of surgery. Quantitative bacterial counts from the conjunctivae and lash lines of each patient were made 24 hours before surgery, on the morning of operation and again 48 hours after surgery. With a regimen of five administrations on the day prior to surgery, neither topical fusidic acid 1.0% nor chloramphenicol 0.5% produced clinically or statistically significant reductions of the ocular microflora. In contrast perioperative subconjunctival cephazolin effectively reduced or eliminated lid and conjunctival microflora following surgery. This study indicates that the effectiveness of a topical antibiotic preparation for overt ocular infection cannot be directly extrapolated to the effect on resident ocular microflora, at least with short-term use for presurgical prophylaxis. 相似文献
From January 1991 to March 1993, a total of 11 infants with positive blood, urine, cerebrospinal fluid (CSF) or stool cultures of Candida albicans were found in the nursery or neonatal intensive care unit of the Chung Shan Medical and Dental College Hospital. Clinical features including respiratory deterioration, poor activity, abdominal distension and/or apnea were noted. Indwelling peripheral venous catheters had been used in all patients to provide parenteral nutrition and broad spectrum antibiotic therapy and six infants had received intravenous fat emulsions. Prolonged endotracheal intubation with mechanical ventilation had been used in eight infants. Six infants (54.5%) had meningitis, five infants (45.5%) had endophthalmitis, and two infants (18.2%) had arthritis. All 11 infants received intravenous amphotericin B therapy, and the concurrent oral administration of 5-fluorocytosine was used in the six infants with meningitis. Three infants died later. Since meningitis was recognized in 54.5% patients and endophthalmitis was recognized in 45.5% patients with systemic candidiasis, the author recommends that culture and analysis of CSF along with indirect ophthalmoscopy should be performed on all infants suspected of having systemic candidiasis. 相似文献
Purpose: To highlight an unusual organism causing a unilateral endophthalmitis by transplacental spread. Method: We report a case of Plesiomonas shigelloides endophthalmitis, presenting in a newborn, with co-existing septicaemia and meningitis. There was a significant maternal history of diarrhoea associated with the ingestion of oysters 2 weeks prior to delivery. Result: The endophthalmitis was treated with parenteral antibiotics and topical mydriatics with complete resolution, although subsequent assessment of the affected eye suggests a poor visual outcome. Conclusion: Endophthalmitis in the newborn is an unusual clinical finding and usually presents with other manifestations of bacteraemia. Plesiomonas shigelloides is fortunately an infrequent cause of neonatal infection, but is associated with a high degree of morbidity and mortality. We postulate that this neonate acquired P. shigelloides via the transplacental route, and suggest that this organism be included in the list of 'other' causes of transplacental infection that has been abbreviated to 'O' in the acronym TORCH. 相似文献
ABSTRACTPurpose: To review the value of next-generation sequencing (NGS) in identifying the pathogens which cause ocular infections, thereby facilitating prompt initiation of treatment with an optimal anti-microbial regimen. Both contemporary and futuristic approaches to identifying pathogens in ocular infections are covered in this brief overview.Methods: Review of the peer reviewed literature on conventional and advanced methods as applied to the diagnosis of infectious diseases of the eye.Conclusion: NGS is a novel technology for identifying the pathogens responsible for ocular infections with the potential to improve the accuracy and speed of diagnosis and hastening the selection of the best therapy. 相似文献