甘孜州汉族中老年人结膜囊细菌状况调查

目的:了解藏区汉族中老年人结膜囊细菌状况。方法:对甘孜州康定县姑咱镇、炉城镇,九龙县呷尔镇的汉族中老年人群173例346眼刮取下睑结膜囊分泌物,接种于血平板,培养48h后进行细菌分离鉴定。结果:选取346眼中结膜囊细菌培养阳性209眼,培养阳性率60.4%。培养出菌株232株,其中表皮葡萄球菌115(49.6%);棒状杆菌60株(25.9%)。康定县姑咱镇、炉城镇的汉族中老年人结膜囊细菌阳性率分别为69.2%和65.8%,差异无统计学意义(χ2=0.1709,P>0.05)。九龙县呷尔镇中老年人结膜囊细菌阳性率为44.3%,分别低于康定姑咱镇、炉城镇的中老年人结膜囊细菌阳性率,差异有统计学意义(姑咱镇vs呷尔镇:χ2=13.2002,P<0.05;炉城镇vs呷尔镇:χ2=9.6869,P<0.05)。结论:甘孜州多数汉族中老年人结膜囊存在细菌;绝大多数细菌为革兰氏阳性菌;表皮葡萄球菌、棒状杆菌是其结膜囊的优势菌种。区域不同,结膜囊细菌阳性率不同。     

藏族与汉族中老年人结膜囊细菌状况对照研究

背景 流行病学调查结果显示,不同民族结膜囊的菌种分布有所不同,可能与其居住环境有关.了解不同民族结膜囊菌种的分布特点对感染性眼病的防治具有重要意义.目的 了解藏族与汉族中老年人结膜囊细菌状况的异同.方法 整群抽取四川甘孜州康定县、九龙县各1个藏族聚居地40岁以上藏族人群145人,九龙县1个及康定县2个汉族聚居地汉族人群173人,共计346眼进行调查,取结膜囊分泌物进行细菌培养及分离鉴定,比较藏族与汉族人群的检查结果.结果 受试的藏族和汉族人群的性别及年龄的差异均无统计学意义(x2=0.987,P=0.320;t=1.142,P=0.254),两组人群农牧民和非农业人口构成比的差异有统计学意义(x2=8.557,p=0.000).藏族人群结膜囊细菌培养阳性率为50.7％,汉族为60.4％,藏族人群结膜囊细菌培养阳性率低于汉族,差异有统计学意义(x2 =6.042,P=0.014).藏族结膜囊多种细菌共存者占11.6％,汉族为11.0％,差异无统计学意义(x2=0.027,P=0.869);藏族人群结膜囊中表皮葡萄球菌培养的阳性率为26.6％,汉族人群为33.2％,差异无统计学意义(x2=3.350,P=0.060);藏族人群结膜囊内棒状杆菌培养的阳性率为15.9％,汉族人群为17.3％;差异无统计学意义(x2=0.248,P=0.618).结论 四川甘孜州藏区藏族中老年人结膜囊细菌培养阳性率较汉族中老年人低,藏族和汉族中老年人结膜囊的细菌的种类及分布相似.     

四川省甘孜州彝族与汉族中老年人结膜囊细菌状况调查研究

目的 了解彝族与汉族中老年人结膜囊细菌分布情况.方法 整群抽取四川省甘孜州儿龙县两个彝族乡聚居点的中老年彝族人群136人(272眼),康定县和九龙县汉族聚居地173人(346眼)取结膜囊分泌物进行细菌培养、分离鉴定.比较彝族与汉族人群结膜囊细菌的情况.结果 彝族人结膜囊细菌培养阳性率(69.9％)较汉族(60.4％)高,差异有统计学意义(x2=5.942 P=0.015).彝族和汉族受检人结膜囊细菌培养阳性的眼中多数为单一菌种,少数为多种菌种,但两个民族多种菌同时存在的构成比差异有统计学意义(x2=10.694 P =0.001),汉族结膜囊多种细菌共存者(11.0％)较彝族多;彝族和汉族结膜囊的优势菌群均为表皮葡萄球菌和棒状杆菌.彝族结膜囊表皮葡萄球菌的阳性率为37.4％,汉族为33.2％,差异无统计学意义(x2=0.924 P=0.336);彝族结膜囊中棒状杆菌的阳性率为32.1％,汉族人群为17.3％;差异有统计学意义(x2=15.296 P=0.000).结论 四川甘孜州藏区彝族中老年人结膜囊细菌培养阳性率较汉族中老年人高,彝族和汉族中老年人结膜囊的细菌多数为单一菌种,少数为多种菌种共存,汉族多种细菌共存较彝族多,两民族结膜囊的优势菌群均为表皮葡萄球菌和棒状杆菌,但彝族结膜囊的棒状杆菌阳性率较汉族高.     

羌族与汉族结膜囊细菌状况对照研究

背景羌族是中国的少数民族,有特定的生活习惯和居住环境,羌族人群的疾病谱以及结膜囊细菌状况是否与汉族有差别是一个值得关注的问题。目的了解羌族与汉族中老年人结膜囊细菌状况的异同。方法研究遵循统一的调查流程及方法。由经过培训的眼科医师整群抽取四川北川县2个羌族聚居点的中老年人106人212眼及居住地地域近似的2个汉族聚居地160人320眼进行眼科检查、问卷调查并睑结膜囊分泌物接种于血琼脂培养基上,培养48h后进行细菌分离鉴定,并对2组受检人群的结果进行比较。结果羌族和汉族受检者的人口基线特征比较差异无统计学意义（X^2=0．32,P=0．57）。羌族中老年人结膜囊细菌培养阳性率为59．43％,汉族为66．30％,差异无统计学意义（X^2=2．27,P=0．13）。羌族结膜囊多种细菌共存者占26．20％,汉族为11．80％;羌族人群中多种细菌共存的构成比明显高于汉族（X^2=106．40,P=0．00）。羌族结膜囊中棒状杆菌培养的阳性率为20．70％,汉族的为45．00％,差异有统计学意义（X^2=31．75,P=0．00）;羌族结膜囊中表皮葡萄球菌培养的阳性率为21．70％,汉族人群为16．6％,差异无统计学意义（X^2=1．89,P=0．17）。结论羌族中老年人结膜囊细菌培养阳性率与汉族中老年人基本相似,羌族和汉族中老年人结膜囊的细菌大多为单一菌株,但羌族人多种菌株共存的现象比汉族更为多见。羌族人与汉族人结膜囊细菌属有一定的区别。     

108例干眼症之结膜囊细菌菌落

连续选取我院角膜病门诊１０８例（２１６只眼）确诊为干眼症患者、２１６例（４３２只眼）正常人分别结膜囊细菌培养，结果说明结膜囊作细菌培养阳性率干眼症患者明显高于正常人（Ｐ〈０．００１），且以致病力较强的绿脓力及金黄色葡萄球菌最多。建议干眼症患者除了给予人工泪液外还应给予预防性抗生素治疗。     

甘孜州藏族与彝族结膜囊细菌状况对照研究

目的:了解藏族与彝族中老年人结膜囊细菌状况的异同。方法:研究遵循统一的调查流程及方法。由经过培训的眼科医师整群抽取四川甘孜州两个藏族聚居点的中老年人145例290眼及居住地地域近似的2个彝族聚居地136例272眼进行眼科检查、问卷调查并睑结膜囊分泌物接种于血琼脂培养基上,培养48h后进行细菌分离鉴定,并对两组受检人群的结果进行比较。结果:藏族和彝族受检者的人口基线特征比较差异无统计学意义(P>0.05)。藏族中老年人结膜囊细菌培养阳性率为50.7%,彝族为69.9%,差异有统计学意义(P<0.05)。藏族结膜囊多种细菌共存者占11.6%,彝族为2.6%;藏族人群中多种细菌共存的构成比明显高于彝族(P<0.05)。藏族结膜囊中棒状杆菌培养的阳性率为15.9%,彝族的为22.4%,差异有统计学意义(P<0.05);藏族结膜囊中表皮葡萄球菌培养的阳性率为26.6%,彝族人群为26.1%,差异无统计学意义(P>0.05)。结论:藏族中老年人结膜囊细菌培养阳性率低于彝族,藏族和彝族中老年人结膜囊的细菌大多为单一菌株,但藏族人多种菌株共存的现象比彝族更为多见。藏族人与彝族人结膜囊细菌菌属有一定的区别。     

人工晶体植入术前老年人结膜囊细菌状况

报道４组老年人人工晶体植入术前的结膜囊细菌状况。第１组术前正常结膜囊阳性率为４５．７％；第２组术日结膜囊组阳性率为１９．２％；第３组切口前结膜囊阳性率为１９．２％；第４组结膜充血组阳性率为５３．１％，与前３组比较差异显著。前三组菌株多数是葡萄球菌结膜３４例次，表皮葡萄球菌最多２２例，金黄色葡萄球菌次之９例。结膜充血组菌种多，仍然是葡萄球菌较多。多数菌株对庆大霉素、先锋霉素和氟哌酸敏感。术前结膜囊有     

广州地区正常人结膜囊真菌和细菌调查

本文报道我国南方正常结膜囊真菌培养178眼,细菌培养137眼.真菌培养阳性者:农民组25%,环卫工人组11.1%,城市普通人群8.8%;细菌培养阳性者:农民组71.9%,环卫工人组80.6%,城市普通人群为23.2%.此外眼部长期用激素者真菌检出率为9.7%,细菌检出率为30%.被检出的真菌株以曲霉菌属和青霉菌属占最多;细菌以葡萄球菌和肺炎球菌占最多.这与临床眼部常见感染的病原菌相类似.虽然结膜囊分离出的菌株,多数为非致病菌或条件致病菌,但在机会感染增加的今天,应强调结膜囊的消毒处理,或条件致病菌,加强眼部感染的预防.     

正常结膜囊细菌的研究

结膜囊正常菌群因不同的环境、年龄、抗生素应用情况,尤其是不同的培养基和取样、培养方法,培养结果差异较大。结膜囊带菌率总体呈下降趋势,凝固酶阴性的表皮葡萄球菌、类白喉杆菌或棒状杆菌、金黄色葡萄球菌始终是最多的几种细菌。     

低浓度聚维酮碘降低结膜囊细菌量的有效性分析

目的:探讨1,5,25g/L三种不同浓度聚维酮碘清除结膜囊细菌的效果及其副作用。方法:采用随机对照性研究方法,选择2009-09/10在武汉爱尔眼科医院行白内障手术的患者205例205眼,用随机数字法分为3组。手术前1d,用3g/L氧氟沙星眼液滴患眼3次。术前约5～10min左右,表面麻醉后依照不同分组分别用1,5,25g/L三种不同浓度聚维酮碘冲洗结膜囊。在下列时间点采集患者结膜囊标本做细菌培养和药物敏感性试验:入院时未用任何药物之前的基准培养;使用1d的3g/L氧氟沙星滴眼液后,未冲洗结膜囊前;聚维酮碘冲洗结膜囊约5～10min后,手术刚开始时;手术结束时。各组间培养阳性率的比较,采用Pearson卡方检验。并注意观察使用聚维酮碘后眼部的不良反应。结果:未用药前,1g/L聚维酮碘组、5g/L聚维酮碘组及25g/L聚维酮碘组结膜囊细菌培养阳性率分别为63.0%,61.4%及59.6%;手术完成后,3组结膜囊培养阳性率分别为12.3%,11.4%及12.9%,各组在用药前与手术结束时的阳性率差别均有显著的统计学意义(χ2值分别为54.88,57.61,40.47,P值均为0)。但是无论是用药前,还是在手术结束时,三组间培养阳性率的差别均无统计学意义(未用药前χ2=0.15,P=0.92;手术结束时χ2=0.06,P=0.96)。62例使用25g/L聚维酮碘患者有4例患者出现结膜充血和轻度角膜水肿,占6%,无其他不良反应,其他2组没有发现明显不良反应,三组间差别有显著的统计学意义(χ2=9.4,P=0.009)。结论:术前使用1g/L低浓度聚维酮碘冲洗结膜囊可以有效清除眼表细菌,和使用25g/L高浓度聚维酮碘的效果相似,而且更为安全。     

Comparison on conjunctival sac bacterial flora of the seniors with dry eye in Ganzi autonomous prefecture

AIM: To compare the bacterial flora in palpebral conjunctiva of xerophthalmia seniors of Tibetan, Yi and Han, and analyze the differences and similarities of the bacteria.METHODS:The test subjects were selected from 2 Tibetan, 2 Yi and 3 Han populated places, respectively. Total 222 seniors (444 eyes) with dry eye were examined. Secretion was collected from the palpebral conjunctiva of the subjects and then inoculated onto a blood agar plate. After 48h of incubation, the bacteria were examined for the differences and similarities between different ethnics.RESULTS: There was no significant difference (P>0.05) of Gram stain characterization, dominant bacteria and number of the bacterial species present in oxrophthalmia patients among Tibetan, Yi and Han nationalities. The bacteria presented in all groups include staphylococcus epidermidis, corynebacterium, micrococcus luteu, intracellular bacteria sphingomonas, pseudomonas aeruginosa. The bacteria detected from the two of three ethnic groups were staphylococcus aureus, staphylococcus haemolyticus, escherichia coli, kytococcus sedentarius, streptococcus angina, micrococcus lylae, and staphylococcus heads. The incidence rate of bacteria-associated dry eye in Tibetan population was significantly lower than that of Han and Yi population.CONCLUSION:There is no significant difference in the bacteria flora of palpebral conjunctiva observed among dry eye elder populations of Tibetan, Yi and Han people. All of staphylococcus epidermidis, corynebacterium, micrococcus luteu, intracellular bacteria sphingomonas, pseudomonas aeruginosa, staphylococcus aureus, staphylococcus haemolyticus, escherichia coli, kytococcus sedentarius, streptococcus angina, micrococcus lylae and staphylococcus heads are common bacteria flora of the three nationalities inhibiting in this area.     

Comparative study of bacterial status from conjunctival sac of the elder Qiang minority and Han people with dry eye in Sichuan, China

AIM: To compare the status of bacteria in the conjunctival sac from the elder Qiang minority and Han people with dry eyes in Sichuan, China. METHODS: Total of 54 elder Qiang people with dry eyes (108 eyes) were examined by cluster sampling. In the similar habitation region of Han people, 80 (160 dry eyes) Han people were analyzed as the control group. The bacteria was separated from the inferior palpebral conjunctiva, then inoculated on blood plate for 48 hours and identified. RESULTS: Totally 24 strains of bacteria were cultured in either Qiang minority or Han c populations with 3 strains of them existed in both ethnic groups. The commonest bacteria in conjunctival sac in two ethnic groups were non-pathogenic bacterium. The composition of Corynebacterium in Han people (54.1%) was significantly higher than that in Qiang minority (27.4%) (χ2=11.6721, P=0.0006). The percentage of Sphingomonas Paucimobilis in Qiang people was higher than that in Han people (χ2=18.6442, P= 0.0000). However, there was no significant difference between Qiang minority and Han people either in bacterial positive rate in conjunctival sac, or the composition of bacteria species and strains, or the composition of staphylococcus epidemids between two ethnic populations. CONCLUSION: There was no significant difference of bacterial positive rate in conjunctival sac from the elder of Qiang minority and Han people with dry eye, but the species of bacteria were different.     

Comparative study of bacterial status from conjunctival sac of the elder Qiang minority and Han people with dry eye in Sichuan, China

AIM: To compare the status of bacteria in the conjunctival sac from the elder Qiang minority and Han people with dry eyes in Sichuan, China. METHODS: Total of 54 elder Qiang people with dry eyes (108 eyes) were examined by cluster sampling. In the similar habitation region of Han people, 80 (160 dry eyes) Han people were analyzed as the control group. The bacteria was separated from the inferior palpebral conjunctiva, then inoculated on blood plate for 48 hours and identified. RESULTS: Totally 24 strains of bacteria were cultured in either Qiang minority or Han c populations with 3 strains of them existed in both ethnic groups. The commonest bacteria in conjunctival sac in two ethnic groups were non-pathogenic bacterium. The composition of Corynebacterium in Han people (54.1%) was significantly higher than that in Qiang minority (27.4%) (χ2=11.6721, P=0.0006). The percentage of Sphingomonas Paucimobilis in Qiang people was higher than that in Han people (χ2=18.6442, P= 0.0000). However, there was no significant difference between Qiang minority and Han people either in bacterial positive rate in conjunctival sac, or the composition of bacteria species and strains, or the composition of staphylococcus epidemids between two ethnic populations. CONCLUSION: There was no significant difference of bacterial positive rate in conjunctival sac from the elder of Qiang minority and Han people with dry eye, but the species of bacteria were different.     

Immune response in the conjunctival epithelium of patients with dry eye

The aim of our project was to test the hypothesis that patients with dry eye have a significant degree of inflammation and lymphocyte infiltration in conjunctival epithelium by using flow cytometry analysis of cells stored in cell culture medium. Impression cytology specimens were collected in 15 normal subjects and 15 dry eye patients. Samples collected from the right eye were placed in Phosphate Buffered Saline containing 0.05% paraformaldehyde (PFA), and samples from the left eye in cell culture medium containing 10% foetal calf serum (FCS). Phenotypic analysis was performed on cells derived from 21 dry eye patients and 16 healthy controls. The cells collected in FCS were stained for the expression of CK19, CD3, CD4, CD8, CD56, CD19, CD20, CD14 and HLA-DR, and analyzed by flow cytometry.FCS samples contained a statistically increased number of cells when compared to PFA samples. No statistically significant differences were present in the number of CD45 + CK19- cells, CD3+ and CD4 + T cells, B and NK cells in dry eye patients compared to healthy controls. In the dry eye group there was a significant difference in the CD4/CD8 ratio respect to what observed in normal subjects, and an increased number of CD14+ cells. HLA-DR expression was increased only in CK19+ conjunctival epithelial cells of dry eye patients.This study indicates that immune cells isolated from the superficial layer of the conjunctiva may play a pivotal role in the pathogenesis of dry eye, and that a new method of preservation of impression cytology samples can enhance flow cytometry analysis of epithelial and immune cells of the conjunctiva.     

正常眼和白内障手术前后结膜囊细菌菌谱及抗生素应用的对比研究

目的检查正常眼的结膜囊存在的细菌种类,并进行药敏分析,对目前临床常用的抗生素滴眼液药效进行对比。方法207例(207眼)正常眼及200例(200眼)白内障的结膜囊标本进行细菌培养,200例白内障分4组给予林可霉素,妥布霉素,氧氟沙星,左氧氟沙星滴眼后术前及手术后再次培养,并将所有培养为阳性的标本进行药敏分析。结果407眼的结膜囊细菌培养阳性率31.45%,其中70岁以上者阳性率最高为42.05%(37/88)。革兰氏阳性球菌阳性率达到80.47%,革兰氏阴性杆菌为16.40%。4种抗生素结膜囊细菌的清除率分别为70.59%、89.47%、94.74%、100.00%;所有白内障眼术前使用抗生素后细菌阳性率为4.00%,手术后1 d拆开眼垫后细菌培养阳性率为6.00%。结论正常眼的结膜囊可有多种细菌存在,高龄者检出率高。其中以表皮葡萄球菌多见,其次为洛菲不动杆菌和金黄葡萄球菌;目前常用的4种抗生素滴眼液的效果强弱不同,提示在临床进行白内障等内眼手术时应根据结膜囊细菌培养的情况选用敏感抗生素,术后也应进行局部抗生素滴眼液的应用。