白内障术前结膜囊细菌培养结果及药敏变化

目的回顾分析近年来白内障患者术前结膜囊细菌构成和对药物敏感情况的变化。方法对1733例眼部无感染的白内障患者术前进行结膜囊细菌培养，并对培养和药物敏感实验结果进行分析。结果白内障患者术前结膜囊细菌培养阳性率为51.6％(894／1733)，主要由革兰阳性球菌(81．4％)和革兰阴性杆菌(12.9％)构成。革兰阳性球菌以表皮葡萄球菌(54．7％)和金黄色葡萄球菌(10.3％)为主，比例呈现逐年升高趋势；革兰阴性杆菌所占比例基本稳定在13％左右。这些结膜囊常见细菌对妥布霉素、环丙沙星和氧氟沙星的耐药率逐年升高，对庆大霉素的耐药率呈下降趋势。结论白内障患者术前结膜囊细菌主要由革兰阳性球菌和革兰阴性杆菌构成，其中革兰阳性球菌比例呈现逐年升高趋势，革兰阴性杆菌比例比较稳定；由于临床上广谱抗生素的广泛、大量应用，这些细菌对常用药物(如环丙沙星、氧氟沙星、妥布霉素)的耐药性逐年增高，对目前不常用的药物(如庆大霉素)的耐药性呈现下降的趋势。

Analysis of bacterial culture results in conjunctival sacs of cataract patients before operation

Objective To analyze the shifting trends of the results of bacterial culture and antibiotics sensitivity tests in conjunctival sacs of cataract patients before operation in recent years.Methods 1733 specimens from the conjunctival sacs of cataract patients in Shandong Eye Institute and Hospital from January 2000 to March 2004 were cultured before operation,and the positive specimens were carried out antibiotics sensitivity tests.Results The number of positive specimens of bacterial culture in non-infectious cataract patients before operation is 894(51.6%)from 1733 specimens.Gram-positive cocci(G~+C,81.4%)and Gram-negative bacilli(G~-B,12.9%)constitute predominant bacteria in the conjunctival sacs of cataract patients before operation.Staphylococcous epidermidis(54.7%)and Staphylococcous aureus(10.3%)was mostly isolated and they trend to increase gradually.The percentage of Gram-negative bacilli kept stable(about 13%).The resistant rate of these bacteria to Tobramycin,Ciprofloxacin,and Ofloxacin is increasing.The resistant rate to Gentamicin has decreased.Conclusions G~+C and G~-B constitute mostly common bacteria in the conjunctival sacs of cataract patients before operation.The percentage of G~+C trends to increase and G~-B keeps stable.The resistant rate of these bacteria to Tobramycin,Ciprofloxacin,and Ofloxacin increases.The resistant rate to Gentamicin decreases.