兰州地区细菌性结膜炎的致病菌分布和耐药性分析

目的 了解兰州地区细菌性结膜炎结膜囊分泌物细菌分布和耐药状况,为细菌性结膜炎的治疗提供依据.方法 2008年10月至2009年12月,在兰州大学第二医院采集急性细菌性结膜炎患者的结膜囊分泌物,进行细菌的分离和鉴定,K-B法对分离细菌做敏感性试验,并对致病菌种类和药物敏感试验结果进行分析.结果 共采集到156例(156只眼)结膜囊分泌物标本,分离细菌116株(74.4％),其中革兰氏阳性细菌有78只眼(67.2％),前三位分别是表皮葡萄球菌29只眼(25.0％)、金黄色葡萄球菌22只眼(19.0％)和腐生葡萄球菌17只眼(14.7％)；革兰阴性细菌38只眼(32.8％),前3位分别是:大肠埃希氏菌25只眼(21.6％)、肺炎克雷伯氏菌7只眼(6.0％)、普通变形杆菌3只眼(2.6％).革兰阳性菌对万古霉素以及革兰阴性菌对加替沙星分别100％敏感,此外所有菌株对其它抗生素均有不同程度的耐药.结论 葡萄球菌等条件致病菌是兰州地区急性细菌性结膜炎的主要致病菌,临床应根据菌株耐药情况合理用药.

Pathogens and their antibiotic sensitivity in acute bacterial conjunctivitis in Lanzhou region

Objective To investigate the distribution and drug resistance of bacteria isolated from secretion of conjunctival sac.Methods From Oct.2008 to Dec.2009,secretion specimens were taken from the inferior conjunctival surface of patients with acute bacterial conjunctivitis,bacteria were isolated and identified,drug resistance were tested with K-B method,the species of bacteria and drug resistance were analyzed.Results A total of 156 secretion specimens were collected,116 (74.4％) strains were isolated,with Gram-positive strain of 78 (67.2％),the first three species were S.epidermidais (25.0％),S.aureus (19.0％) and S.saprophyticus; With Gram-negative strain of 38 (32.8％),the first three species were 25 (21.6 ％) of E.coli,7(6.0 ％) of K.penmoniae and 3 (2.6％) of P.vulgaris.Gram-positive and Gram-negative strains were 100％ sensitive to vancomycin and gatifloxacin,respectively.Besides,all the other strains were resistance to other antibiotics with different degree.Conclusions Some opportunistic bacteria including staphylococci have become the majority of pathogenic bacteria of conjunctivitis in Lanzhou,the drug treatment should be used combined with drug sensitivity.