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1.
新生儿急性细菌性结膜炎10年致病菌变迁   总被引:2,自引:0,他引:2  
对1998~2007年临床确诊的新生儿急性细菌性结膜炎的细菌培养结果进行分析,探讨其致病菌10年的变迁,为临床治疗、合理用药提供依据.方法 对325例(466只眼)经临床诊断为新生儿急性细菌性结膜炎患儿的结膜囊分泌物标本进行细菌培养,同时对培养阳性的菌株进行鉴定分析.结果 新生儿急性细菌性结膜炎的细菌平均检出率为80%.不同年分的细菌检出率变化无明显差异(x2=0.83,P>0.05).10年来,新生儿急性细菌性结膜炎的致病菌中革兰阳性细菌有逐渐减少、革兰阴性细菌有逐渐增加的趋势.在革兰阳性细菌中,条件致病菌(表皮葡萄球菌和腐生匍萄球菌)所占的百分比有逐年增加的趋势,金黄色葡萄球菌和溶血性链球菌所占的百分比则有逐年减少的趋势.在革兰阴性菌中,淋球菌为主要致病菌.10年来,表皮葡萄球菌、腐生葡萄球菌和淋球菌在新生儿急性细菌性结膜炎的致病菌中有逐渐增加的趋势.结论 对新生儿急性细菌性结膜炎患儿的结膜囊分泌物标本进行细菌培养、药物敏感试验既助于提高临床治疗,又可防止临床滥用抗生素、造成耐药菌株的增加.对于严重的新生儿急性细菌性结膜炎,早期可慎片喹诺酮类抗生素滴眼液治疗,待细菌培养和药物敏感试验结果报告后再结合治疗情况修改治疗方案.
Abstract:
Objective To study the results of bacterial culture from the inferior palpebral conjunctival surface of neonate with acute bacterial conjunctivitis and research the transition of bacterial pathogens in recent 10 years for sensitive antibiotics for its treatment,and to provide the basis for rational drug use for clinical treatment.Methods Secretion specimens were taken from 466 eyes of 325 cases with clinically diagnosed acute bacterial neonatal conjunctivitis for bacterial culture,and drug sensitivity test was carried out for specimens with positive culture results.Results Bacterial positive rate was 80% with insignificant changes among the different years.The past 10 years,neonatal conjunctivitis of acute bacterial pathogens,Gram-positive bacteria had a gradual downward trend;Gram-negative bacteria had a gradual upward trend.In Gram-positive bacteria,the percentage of opportunistic pathogen (Staphylococcus epidermidis and Staphylococcus saprophytic) was a rising trend,the percentage of Staphylococcus anreus and hemolytic streptococcus was a decreasing trend.In the Gram-negative bacteria,the main pathogenic bacteria were Neisseria gonorrhoeae.Staphylococcus epidermidis,Staphylococcus saprophytic and Neisseria gonorrhoeae in neonatal pathogens of acute bacterial conjunctivitis had a gradual upward trend in recent 10 years.Conclusions Bacterial culture combined with drug sensitivity test of secretion specimens of the acute bacterial neonatal conjunctivitis are beneficial not only for clinical treatment,but also to guide clinical practice in preventing antibiotics misuse and causing an increase in resistant strains.For serious neonatal acute bacterial conjunctivitis,the early quinolone antibiotic eye drops can be used with caution.After the results of bacterial culture and drug sensitivity test,the treatment programs should be modified.  相似文献   

2.
目的 探讨我国最新急性细菌性结膜炎致病菌的种类。方法 对50例(50眼)急性细菌性结膜炎患者结膜囊分泌物进行细菌学检查,给予患者10g·L-1阿奇霉素滴眼液滴眼,每天2次,滴眼2d后改为每天1次,治疗3d,于第8天再次行细菌培养检查。结果 急性细菌性结膜炎结膜囊分泌物细菌培养阳性率80.0%,革兰阳性细菌占97.5%,表皮葡萄球菌占首位(占培养阳性总数72.5%),其中包括2例苯唑西林耐药表皮葡萄球菌。应用抗生素治疗后,47例(94.0%)患者临床症状缓解。再次行病原学检查,原致病菌全部清除率为60.0%,部分清除率为5.0%。治疗后细菌培养仍阳性细菌主要为表皮葡萄球菌(占培养阳性总数56.2%)。结论 表皮葡萄球菌已成为我国目前急性细菌性结膜炎的首要致病菌,在临床工作中应对其予以重视,选择针对性治疗。  相似文献   

3.
我国急性细菌性结膜炎最新病原学分析   总被引:1,自引:0,他引:1  
目的 探讨我国急性细菌性结膜炎最新致病菌的种类.方法 对52例(89眼)急性细菌性结膜炎患者结膜囊分泌物进行细菌学检查,给予患者氟喹诺酮类抗生素1d4次滴眼治疗7d后,于第8天再次行细菌培养检查.结果 急性细菌性结膜炎患者结膜囊分泌物细菌培养阳性率78.65%,其中,革兰阳性细菌81.43%,以表皮葡萄球菌(80.70%)及金黄色葡萄球菌(10.53%)占其前2位;革兰阴性细菌18.57%,其中不动杆菌居首位(38.46%).应用抗生素治疗7d后,所有患者临床症状均治愈,再次行病原学检查,病菌转阴率为85.71%.治疗后细菌培养仍阳性的7例患者(10眼)细菌培养结果全部为表皮葡萄球菌.结论 表皮葡萄球菌已成为我国目前急性细菌性结膜炎的首要致病菌,在临床工作中应对其予以重视.  相似文献   

4.
氧氟沙星滴眼治疗急性细菌性结膜炎的观察   总被引:1,自引:0,他引:1  
对60例急性细菌性结膜炎患者随机分两组,一组30例,用0.3%氧氟沙星滴眼治疗1周,治愈35例,50眼细菌培养为阴性;另一组30例,用0.3%诺氟沙星滴眼治疗1周,治愈22眼,41眼细菌培养为阴性,两组无显著差异。  相似文献   

5.
目的观察急性细菌性结膜炎治疗前后的眼表改变,为进一步了解急性细菌性结膜炎病理过程及治疗提供依据。方法对51例(72眼)确诊为急性细菌性结膜炎者给予抗生素滴眼液治疗,分别于首次就诊当天、治疗后1周、2周、3周、1个月行患眼基础泪液分泌试验、泪膜破裂时间、角膜荧光素染色检查,对检查结果进行统计学分析。结果基础泪液分泌试验结果显示:首次就诊当天为(7.6±2.7)mm,治疗后1周、2周、3周、1个月分别为(5.8±2.7)mm、(8.8±3.5)mm、(9.3±2·4)mm、(11.9±3·4)mm,与正常人群12.5mm比较,治疗后1周、2周、3周差异均有显著统计学意义(均为P<0.01),治疗后1个月差异无统计学意义(P>0.05)。泪膜破裂时间结果显示:首次就诊当天为(6.8±3.0)s,治疗后1周、2周、3周、1个月分别为(6.2±2.6)s、(8.6±3.6)s、(8.4±4.0)s、(24.3±3.9)s,与正常人群25.0s比较,治疗后1周、2周、3周差异均有显著统计学意义(均为P<0.01),治疗后1个月差异无统计学意义(P>0.05)。角膜荧光素染色显示:首次就诊当天阳性49眼,治疗后1周、2周、3周、1个月阳性分别为50眼、36眼、30眼、10眼。结论急性细菌性结膜炎发病时及治疗恢复过程中会出现干眼症状的眼表改变,在治疗中可考虑使用药物进行改善。  相似文献   

6.
将60例102眼急性细菌性结膜炎患者随机分配成两组,其中用0.3%Ofloxacin(OFLX)滴眼液治疗54眼,0.3%Norfloxacin(NFLX)滴眼液治疗48眼,疗程为一周。患者均选择细菌培养为阳性者。OFLX治疗组54眼中痊愈35眼,显效15眼,总有效率92.5%,而NFLX治疗组48眼中痊愈22眼,显效20眼,总有效率87.5%。治疗后细菌培养转阴性者,OFLX治疗组54眼中有50眼,NFLX治疗组48眼中有41眼。根据临床和微生物学研究,我们认为OFLX滴眼液相对优于NFLX滴眼液,但无统计学差异(P>0.05)。  相似文献   

7.
新生儿急性细菌性结膜炎病原菌及药物敏感性分析   总被引:3,自引:1,他引:3  
目的探讨近年来新生儿急性细菌性结膜炎主要致病菌的特点及药物敏感试验结果,为临床寻找该疾病的有效抗生素和合理用药提供科学依据。方法对近5年临床诊断为新生儿急性细菌性结膜炎的82例患儿 (129只眼),进行结膜囊分泌物的细菌培养和种类鉴定,并对阳性培养菌株进行药物敏感试验和分析。结果新生儿急性细菌性结膜炎的细菌平均检出率为76.0%。不同年份的细菌检出率变化不明显(x2=0.80,P>0.05)。根据培养结果,新生儿急性细菌性结膜炎的致病菌,由以往金黄色葡萄球菌、草绿色链球菌为主,转变为以淋球菌、表皮葡萄球菌和腐生葡萄球菌为主。大多数细菌对环丙沙星敏感,对氯霉素耐药。结论新生儿急性细菌性结膜炎的致病菌株同以往相比较发生了较大的改变,其耐药性也发生了相应的改变。  相似文献   

8.
目的 探讨加替沙星滴眼液治疗细菌性结膜炎的临床效果.方法 加替沙星组和氧氟沙星组各为120例,合计240例.采用计算机编程随机法,随机双盲对照试验.患者的纳入应能满足所有入选及排除标准,随机分为加替沙星组和氧氟沙星组,分别给予加替沙星滴眼液和相同浓度对照药氧氟沙星滴眼液,疗程7~14天.加替沙星滴眼液组:每日5次,每次1~2滴,滴入结膜囊内,氧氟沙星滴眼液组:每日5次,每次1~2滴,滴入结膜囊内,随诊观察.结果 本研究共分离临床敛病菌67株,其对加替沙星、氧氟沙星、左氧氟沙星和环丙沙星的敏感率分别为98.51%、85.07%、95.52%、78.79%.表明加替沙星的细菌敏感率最高,与氧氟沙星比较,差异有统计学意义.加替沙星滴眼液治疗细菌性结膜炎的疗效不低于氧氟沙星滴眼液.结论 结果表明,加替沙星滴眼液抗菌谱广、抗菌活性强,与氧氟沙星滴眼液疗效相当,安全性好,适于作为细菌性结膜炎的治疗用药.同时对革兰阳性菌和革兰阴性菌感染的眼表疾病,都有一定的治疗效果.
Abstract:
Objective To study the clinical efficacy of gatifloxacin eye drops for bacterial conjunctivitis.Methods A total of 240 cases that diagnosed as bacterial conjunctivitis were randomly divided into test group (gatifloxacin) and control group (floxacin).A random double-blind and paralled study was conducted on 120 cases with gatifloxacin and floxacin eye drops for bacterial conjunctivitis.The drug delivery into conjunctival sac was performed at 7-14 days (one-two drops per time, five times per day).Results Sixty-seven clinical common pathogenic bacteria were separated from the study.The antibacterial activity of gatifloxacin,floxacin, levofloxacin, ciprofloxacin was 98.51%, 85.07%, 95.52%, and 78.79% respectively.The antibacterial activity of gatifloxacin was the highest, and the statistic difference between gatifloxacin and floxacin was found.The effect of gatifloxacin eye drops was not worse than floxacin eye drops.Conclusions The gatifloxacin eye drops has characteristics with broad spectrum, powerfull antibacterial activity.The linical effect of gatifloxacin eye drops is the same with floxacin eye drops.Gatifloxacin eye drops are safe and can be used to treat bacterial conjunctivitis.It has comparatively theropic value of ocular surface disease with Gram-positive bacterial and Gram-negetive bacterial.  相似文献   

9.
通过对235例婴儿细菌性结膜炎的病原菌及药敏试验,采用妥布霉素、庆大霉素、氧氟沙星眼液分组对照治疗观察。结果表明三种药物的总药敏度分别是89.39%、39.39%和65.66%。临床总有效率分别是92.00%、54.00%和72.00%,总药敏度与临床总有效率基本一致。妥布霉素不仅广谱且抗菌作用最强,还发现有对绿脓杆菌作用突出的特点,其眼民适用于婴儿。  相似文献   

10.
根据慢性结膜炎的临床症状(自觉眼干涩、痒、烧灼感、疲劳感或阅读困难),临床体征(轻微结膜充血、乳头肥大、结膜肥厚充血,血管纹理模糊、少量分泌物)等表现,随机选取我院2005年1~6月间50位门诊病人进行结膜刮片,革兰染色及细菌培养,根据染色及培养结果以探讨慢性结膜炎病因及治疗方法,现总结分析如下。  相似文献   

11.
304例化脓性眼内炎细菌培养结果分析   总被引:26,自引:1,他引:26  
Lu J  Lin Z  Zou Y 《中华眼科杂志》2000,36(5):355-357
目的 分析化脓性眼内炎的细菌培养结果,寻找治疗有效的抗生素。方法 对304例(304只眼)经临床诊断为化脓性眼内炎患者的玻璃体液进行细菌培养,同时对培养阳性菌株的种类及药物敏感试验结果进行分析。结果 细菌检出纺为53%,不同年份的细菌检出率变化不明显(X^2=9.29,P〉0.05),敏感抗生素为头孢哌酮。结论 经玻璃体腔抽取的玻璃体液标本进行细菌培养有助于指导化脓性眼内炎的治疗。  相似文献   

12.
AIM: To evaluate the relative efficacy and safety of besifloxacin for treatment of acute bacterial conjunctivitis. METHODS: A comprehensive search in PubMed, EMBASE Web of Science, Cochrane Central Database and CNKI was undertaken for randomized controlled trials (RCTs) comparing besifloxacin with other treatments or placebo. The primary outcome measures were clinical resolution, rates of bacterial eradication, individual clinical outcomes, cure rates, and bacterial eradication rates of different kinds of pathogens. Safety outcomes were the number of adverse effects (AEs). The final search was performed on August 2018. RESULTS: Six RCTs were included. Four studies compared the efficacy and safety of besifloxacin with placebo, 1 study compared besifloxacin with moxifloxacin, and 1 study compared besifloxacin with gatifloxacin. A total of 2780 patients met the inclusion criteria. Besifloxacin presented higher efficacy and safety than did placebo in clinical resolution, rates of bacterial eradication, individual clinical outcomes, cure rates, bacterial eradication rates of different kinds of pathogens and the number of AEs. There was no significant difference between besifloxacin and moxifloxacin or gatifloxacin in the comparison items mentioned above. CONCLUSION: Besifloxacin is highly effective and safe for treatment of acute bacterial conjunctivitis. Further comparative trials regarding the effect of besifloxacin for treatment of acute bacterial conjunctivitis will aid in treatment decisions.  相似文献   

13.
目的对2001年至2010年临床确诊的新生儿淋菌性结膜炎的病人结膜囊分泌物进行细菌培养和药物敏感性试验,探讨其致病菌药物敏感性10年的变迁,为临床合理用药提供依据。方法对78例临床诊断为新生儿淋菌性结膜炎患儿的结膜囊分泌物标本进行细菌培养,对培养出的淋球菌进行药物敏感性试验,并对数据进行分析。结果 10年来,新生儿淋菌性结膜炎的致病菌——淋球菌对头孢哌酮、头孢唑啉、环丙沙星和妥布霉素的药物敏感性高,对利福平、新霉素、氯霉素的耐药性强。结论新生儿淋菌性结膜炎首选环丙沙星眼药水和妥布霉素眼药水。病情严重者可以联合头孢哌酮或者头孢唑啉类的药物,同时应及早取标本进行细菌培养和药物敏感试验,以便在试验结果出来之后,及时修改治疗方案,以取得更好的临床效果。  相似文献   

14.
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