急性泪囊炎致病菌分布及药物敏感性分析

目的:探讨急性泪囊炎致病菌和耐药性,为临床合理用药提供依据。方法:2014-01/2019-10在河北省眼科医院搜集80例急性泪囊炎患者,并抽取泪囊脓液标本做细菌培养及药物敏感试验,分析各年份致病菌菌株的检出率变化,被送检急性泪囊炎致病菌菌种种类,急性泪囊炎的主要致病菌、药物敏感及耐药情况,急性泪囊炎的致病菌平均检出率。结果:56例标本的致病菌菌株阳性,其中55例为细菌、1例为真菌,平均检出率为70%。各年份致病菌菌株的检出率呈逐渐降低趋势,被送检急性泪囊炎致病菌菌种种类繁多。革兰氏阳性球菌构成急性泪囊炎的主要致病菌,占68%(38例),以金黄色葡萄球菌为主,占38%(21例)。大部分革兰氏阳性球菌对利福平、左氧氟沙星、氯霉素敏感。革兰氏阴性杆菌对妥布霉素、左氧氟沙星、环丙沙星、庆大霉素较敏感。55例细菌标本对第一、二代头孢菌素有明显耐药。结论:革兰氏阳性球菌构成急性泪囊炎的主要致病菌,左氧氟沙星可作为治疗急性泪囊炎的首选局部用抗生素。     

泪小管炎主要临床特征及致病菌分析

目的：探讨泪小管炎的主要临床特征、致病菌分布及其药物敏感性特征,为临床诊治提供依据。

方法： 回顾性研究。选择2016-12/2020-10于河北省眼科医院确诊为泪小管炎的患者45例45眼,分析患者的一般资料、临床表现及治疗史、细菌培养及药物敏感性试验结果。

结果：纳入的45例患者均单眼发病,其中21眼表现为流泪、分泌物增多、内眦部结膜充血,14眼表现为内眦部红肿,6眼表现为类似眼睑囊肿,行常规术前检查时发现并诊断4眼。既往被诊断为其他眼部疾病27眼,误诊率为60.0%。细菌培养阳性率为80.0%(36/45),以表皮葡萄球菌最为常见,其次为链球菌属; 多重耐药菌感染患者占52.8%(19/36)。细菌对氟喹诺酮类抗生素敏感率(82.9%,97/117)高于氨基糖苷类(70.1%,68/97)和头孢菌素类(68.1%,111/163)抗生素; 除万古霉素以外,利福平、左氧氟沙星、氯霉素对革兰氏阳性菌的敏感性较高。

结论：表皮葡萄球菌是泪小管炎最常见致病菌、其次为链球菌属; 左氧氟沙星、利福平可作为局部抗感染的首选抗生素,合理用药可减少多重耐药菌形成; 行泪小管切开成形术彻底清除结石,可提高治愈率。     

婴幼儿泪囊炎致病菌分布和药物敏感性分析

目的 探讨婴幼儿泪囊炎致病菌和耐药性,为临床合理用药提供依据.方法 实验研究.2004年8月至2008年8月在沈阳市儿童医院参照<全国临床检验操作规程>的检验程序搜集230例婴幼儿泪囊炎患儿(年龄范围2d至10个月,平均为90d)的挤压泪囊部反流的脓汁标本做细菌培养及药物敏感试验,针对结果分析各年份致病菌菌株的检出率变化,被送检婴幼儿泪囊炎致病菌菌种种类,婴幼儿泪囊炎的主要致病菌,婴幼儿泪囊炎的致病菌平均检出率,大多数致病菌对何种药物敏感,何种药物耐药.结果 婴幼儿泪囊炎的致病菌平均检出率为87.0%(200例).各年份致病菌菌株的检出率变化无明显差异,被送检婴幼儿泪囊炎致病菌菌种种类繁多.革兰阳性球菌构成婴幼儿泪囊炎的主要致病菌,占74.5%(149例),其中凝固酶阴性葡萄球菌占20.5%(41例).其次是金黄色葡萄球菌占11.0%(22例);还包含极少见的致病菌菌种.大多数致病菌对妥布霉素、环丙沙星、左氧氟沙星敏感.在革兰阳性球菌中,凝固酶阴性葡萄球菌、金黄色葡萄球菌对妥布霉素、左氧氟沙星最为敏感.革兰阴性杆菌对妥布霉素、氯霉素最为敏感,敏感率均达96.67%(均29例);对红霉素和青霉素的敏感率最低,耐药率分别达66.67%(20例)和80.00%(24例).结论 凝固酶阴性葡萄球菌已成为婴幼儿泪囊炎的主要致病菌.     

中国白内障人群术前结膜囊细菌培养结果的Meta分析

目的：系统研究中国白内障人群术前结膜囊细菌构成和药物敏感情况的变化,为白内障术前无菌化准备提供科学的理论依据。

方法：计算机检索中文科技期刊数据库、万方数据库、中国知网学术文献网络出版总库及中文生物医学文献数据库。收集2004-01/2013-09发表的有关中国人群白内障结膜囊细菌培养的文献,并辅以手工检索、因特网搜索。并采用Meta分析对所纳入研究结果进行分析。

结果：共纳入7篇文献,共11499眼,白内障患者术前结膜囊培养阳性率为26.03%(2993/11499),主要由G⁺球菌(86.40%)、G⁺杆菌(8.10%)、G^-杆菌(4.13%)以及G^-球菌(1.37%)构成。G⁺球菌主要以表皮葡萄球菌(67.30%)、金黄色葡萄球菌(12.53%)和微球菌(6.98%)为主。大多菌株对妥布霉素、万古霉素、环丙沙星和庆大霉素敏感,对妥布霉素和环丙沙星耐药性有上升趋势。

结论：白内障术前的结膜囊主要由表皮葡萄球菌构成,对青霉素和红霉素耐药,大多数菌株对妥布霉素、万古霉素、环丙沙星和庆大霉素敏感,对妥布霉素和环丙沙星耐药性有上升趋势。     

慢性泪囊炎患者优势致病菌及耐药性分析

目的:分析慢性泪囊炎患者的优势菌变迁及对抗生素的敏感性。方法:对40例慢性泪囊炎患者的泪囊分泌物取样,进行细菌培养、分离、鉴定及药物敏感实验。结果:40例慢性泪囊炎患者泪囊分泌物培养,39例为阳性,共分离出50株阳性菌。G+球菌27株(54%),其中表皮葡萄球菌22株(44%),G-杆菌为14株(28%)。表皮葡萄球菌对利福平的敏感率为91%,左氧氟沙星66%,氧氟沙星60%。结论:G+球菌为引起慢性泪囊炎的主要菌,其中表皮葡萄球菌为优势菌,应重视老药新用及一线药物耐药性的变迁,结合药敏结果合理选用抗生素。     

准分子激光原位角膜磨镶术前结膜囊细菌分析

目的观察准分子激光原位角膜磨镶术(1aser in situ keratomileusis，LASIK)术前患者结膜囊细菌分布及药物敏感性。方法对LASIK术前100例患者(200只眼)结膜囊取材进行细菌培养，并观察培养阳性的细菌对10种常见抗生索的体外药物敏感性。结果在200只眼结膜囊标本中细菌培养阳性者58眼(71株)，阳性率29%，共分离鉴定出12个细菌种属；其中革兰氏阳性菌为85．9％，革兰氏阴性菌为14．1％；金黄色葡萄球菌、表皮葡萄球菌、棒状杆菌属及假单胞菌属为LASIK术前患者结膜囊存在的常见菌属。药敏结果发现所分离细菌对阿米卡星和左氧氟沙星最敏感。结论革兰氏阳性菌是LASIK术前患者结膜囊存在的最常见菌，术前预防性抗生素使用应注意选择对革兰氏阳性菌敏感的抗生素。     

邢台地区急性细菌性结膜炎病原菌分布及药敏分析

目的：了解本地区急性细菌性结膜炎病原菌的种类分布及其对常用药物的敏感性,为临床诊断和治疗提供依据。方法：收集2010-01/2012-12河北邢台眼科医院诊治的急性细菌性结膜炎患者的结膜囊分泌物进行细菌学检查,并对致病菌种类及药敏试验结果进行分析。
　　结果：检标本186例中,培养阳性菌150例(80.6%),其中革兰氏阳性菌127例(84.7%),占前三位的分别是表皮葡萄球菌(28.0%),人葡萄球菌(10.0%),溶血葡萄球菌(4.0%)。革兰氏阴性菌23例(15.3%),前四位的分别是：大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、阴沟肠杆菌,均为2.0%。革兰氏阳性菌除对万古霉素敏感率为100%外,对其他抗菌药物均有不同程度的耐药性。革兰氏阴性菌中敏感率最高的是头孢哌酮(87.0%)。
　　结论：表皮葡萄球菌等条件致病菌已成为本地区急性细菌性结膜炎的主要致病菌。无论革兰阳性菌还是革兰阴性菌对临床常用抗菌药物耐药性均较高。尽早获取结膜囊分泌物进行细菌培养和药敏试验,对于临床诊断及合理选择抗生素治疗意义重大。     

产后常规按摩泪囊预防新生儿泪囊炎

目的：对新生儿进行早期预防性按摩泪囊,以预防及减少新生儿泪囊炎发生。

方法：收集4 048例新生儿(顺产2 650例5 300眼,剖宫产1 398例2 796眼)。对2 131例(顺产1 396例2 792眼,剖宫产735例1 470眼)进行预防性按摩泪囊,未按摩1 917例(顺产1 254例2 508眼,剖宫产663例1 326眼)作为对照组。在观察周期内判断是否发生泪囊炎。

结果：预防性按摩泪囊后,有104例(顺产68例75眼,剖宫产36例47眼)发生新生儿泪囊炎,对照组发生泪囊炎140例(顺产49例57眼,剖宫产91例148眼)。新生儿泪囊炎发生率在预防性按摩组与对照组中比较,差异有统计学意义(χ ²=32.141,P<0.001)。

结论：预防性按摩泪囊可以预防及减少新生儿泪囊炎的发生。     

慢性泪囊炎致病菌分布及药物敏感性分析

目的：分析慢性泪囊炎致病菌和药物敏感性的现状,为临床合理用药提供依据。
　　方法：对171例慢性泪囊炎患者的泪囊分泌物取样,做病原菌培养鉴定及药物敏感试验。针对结果分析慢性泪囊炎致病菌菌株的检出率,慢性泪囊炎致病菌菌种种类,慢性泪囊炎的主要致病菌,大多数致病菌对何种药物敏感。结果：慢性泪囊炎的致病菌检出率为76.61%(131例)。革兰阳性球菌构成慢性泪囊炎的主要致病菌,占72.52%(95例),其中人葡萄球菌占27.48%(36例),表皮葡萄球菌占16.79%(22例),草绿色链球菌占12.98%(17例)。大多数致病菌对头孢哌酮/舒巴坦、妥布霉素、庆大霉素、左氧氟沙星敏感,其中革兰阳性球菌中对头孢哌酮/舒巴坦、庆大霉素、妥布霉素最为敏感,革兰阴性杆菌对头孢哌酮/舒巴坦、妥布霉素、左氧氟沙星最为敏感。
　　结论：人葡萄球菌成为慢性泪囊炎的主要致病菌,妥布霉素可作为治疗慢性泪囊炎的首选局部用抗生素。     

先天性鼻泪管阻塞致泪囊炎的病原菌及药敏结果分析

目的：分析小儿先天性鼻泪管闭塞所致泪囊炎的病原菌及其药敏结果,指导临床合理用药。 方法：对先天性鼻泪管阻塞患儿98例110眼的泪囊分泌物进行病原菌分离培养及药物敏感试验。 结果：从94眼的分泌物中共分离出155株细菌,病原菌阳性率为85.5%。其中革兰氏阳性球菌65.8%,革兰氏阴性杆菌23.9%。分离出的所有菌株对左氧氟沙星的敏感率为94.2%。 结论：药敏试验表明绝大多数细菌对左氧氟沙星有较高的敏感性,对于小儿先天性鼻泪管闭塞所致泪囊炎可给予新喹诺酮类抗生素滴眼液治疗。     

泪小管炎的优势致病菌及药物敏感性分析

目的：研究泪小管炎的主要致病菌及药物敏感性,为临床合理用药提供依据。
　　方法：选取西安市第一医院就诊的泪小管炎患者57例57眼,取泪小管分泌物行细菌培养及药敏试验;对泪小管内排出的硫磺颗粒碾开涂片以寻找放线菌。
　　结果：泪小管炎患者57例57眼中,有56眼挤压泪小管见硫磺颗粒经泪点排出,取硫磺颗粒碾开涂片均见放线菌。57眼患眼取泪小管分泌物进行细菌培养,55眼为阳性,共培养出菌株63株,主要为表皮葡萄球菌、草绿色链球菌和肺炎球菌,其他菌种少见。药物敏感性试验结果显示：利福平、头孢西丁、氯霉素、美洛西林等药物敏感性较高。
　　结论：放线菌为泪小管炎的主要致病菌,且大部分存在于其他细菌的合并感染。利福平、头孢西丁、氯霉素、美洛西林等药物治疗泪小管炎敏感性高。     

Distribution of pathogenic bacteria and antimicrobial sensitivity of eye infections in Suzhou

AIM: 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. CONCLUSION: 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.     

Bacteriological Evaluation of Adult Dacryocystitis in Iran

Purpose: To examine the microbiology and antibiogram of specimens from patients with dacryocystitis.

Methods: A total of 66 samples from lacrimal sac contents of 61 consecutive patients with acute and chronic dacryocystitis were obtained. These specimens were cultured for bacteria with a routine microbiological technique. Antibiograms were acquired from positive cultures.

Results: A total of 61 patients (12 patients with acute and 49 patients with chronic dacryocystitis) were included in this investigation with the average age of 40 (12–85) years (female?=?74% and male?=?26%). Five patients were culture-negative and five patients had mixed gram-positive cultures (a total of 66 samples were obtained). The total prevalence of gram-positive, gram-negative, and culture-negative samples were 71.2%, 21.2%, and 7.6%, respectively. The prevalence of gram-positive, gram-negative, and culture-negative samples were 77.4%, 18.9%, and 3.8% in the chronic and 46.2%, 30.8%, and 23.1% in the acute groups, respectively. The most prevalent pathogen in both groups was Staphylococcus epidermis. In 38% of patients the culture results were similar to those of the contralateral conjunctival flora. Gram-negative bacteria had a high sensitivity to ciprofloxacin and cephalexin while the gram-positive ones were highly sensitive to ceftriaxone and ampicillin.

Conclusion: The responsible pathogens in acute and chronic dacryocystitis are significantly different. Because of the high prevalence of gram-negative bacteria and also culture-negative samples and considering the necessity of treatment in acute dacryocystitis, selecting an appropriate antibiotic with a good coverage of gram-negative and gram-positive bacteria seems essential.