新型 OxyPlate~（TM）厌氧系统隔离眼部厌氧菌的评估（英文）

目的：厌氧细菌可引起眼部感染,我们测试OxyPlate~（TM）厌氧系统（OxyPlate~（TM） Anaerobic System,OXY）隔离可引起眼部疾病的厌氧细菌。方法：OXY不需要直接的厌氧条件（比如厌氧袋,罐）,将其与常规的厌氧袋培养基相比。琼脂培养基上眼部厌氧细菌菌株在好氧和厌氧条件下（厌氧袋）行标准的菌落计数：（1）OXY（好氧）;（2）5%羊血（sheep blood,SB）;（3）巧克力琼脂;（4）Schaedler琼脂。测试的眼部体外培养细菌来自眼内炎,泪囊炎,包括10个丙酸杆菌和3个放线菌种类。在每个培养条件下,每个细菌菌落计数隔离,排名从大到小,并在非参数比较下确定最佳的培养条件。结果：所有的厌氧条件对于厌氧菌株呈阳性反应。厌氧菌在有氧条件下的SB和Schaedler的琼脂中无法增长。痤疮丙酸杆菌在巧克力琼脂中生长稀疏。作为一种厌氧系统,在厌氧袋SB分离比OXY（P=0.0028）和巧克力琼脂（P=0.0028）分离出更多的菌落数。结论：虽然OXY经测试并没比其他的厌氧系统更高效,它似乎是一个合理隔离厌氧细菌的替代方法。其琼脂培养基在一个专门设计的盘并不需要厌氧袋使得OXY优于其他厌氧系统。     

不同材料人工晶状体表面表皮葡萄球菌黏附实验的研究

背景感染性眼内炎是白内障摘出及人工晶状体（IOL）植入术后最严重的并发症之一,细菌黏附于IOL表面随手术带人眼内是其主要原因,了解细菌对IOL的黏附情况对预防术后眼内炎的发生具有重要意义。目的研究不同材料的IOL光学表面表皮葡萄球菌的黏附情况,比较细菌培养菌落计数及扫描电子显微镜计数2种方法的优缺点。方法疏水性丙烯酸酯IOL、聚甲基丙烯酸甲酯IOL（PMMAIOL）、肝素修饰聚甲基丙烯酸甲酯（HSM—PMMAIOL）、硅凝胶IOL（SIIOL）、亲水性丙烯酸酯IOL5种不同材料的IOL（每种6枚）置于表皮葡萄球菌（ATCC12228）细菌悬液1h后,采用细菌培养菌落计数及扫描电子显微镜2种方法观察表皮葡萄球菌在各种IOL表面的黏附数量。结果细菌培养菌落计数发现疏水性丙烯酸酯IOL和PMMAIOL最易于黏附细菌,亲水性丙烯酸酯和HSM—PMMAIOL黏附的细菌最少,5种IOL中细菌黏附数的比较差异有统计学意义（F=100．084,P=0．000）,亲水性丙烯酸组和HSM—PMMA组间差异无统计学意义（t=2．285,P=0．052）;扫描电子显微镜观察结果显示5种IOL组细菌在IOL上光学分布表面计数的总体比较差异有统计学意义,按照细菌在IOL上黏附的数量从多到少依次为Hydrophobie〉PMMA〉SI〉Hvdrophilic〉HSM—PMMA（F：118．065,P=0．000）。两种细菌菌落计数方法比较发现扫描电子显微镜法优于细菌培养菌落计数法,差异有统计学意义（t=5．019,P=0．000）。结论5种IOL中以亲水性丙烯酸酯和HSM～PMMAIOL黏附的细菌最少,提示亲水性丙烯酸酯IOL和HSM—PMMAIOL在降低白内障IOL植入术后眼内炎的发生方面有一定的作用。     

眼部机会感染的误诊分析

目的探讨眼部机会感染误诊的原因。方法对４例（６只眼）的眼部机会感染患者的误诊原因进行分析。结果棘阿米巴性用膜炎误诊为单疮病毒性角膜炎和真菌性角膜炎１例（１只眼）；痤疮丙酸杆菌性眼内炎误诊为外源性真菌性眼内炎１例（１只眼）；内源性真菌性眼内炎误诊为脉络膜转移性肺癌１例（２只眼）；巨细胞病毒性视网膜炎误诊为内源性真菌性眼内炎１例（２只眼），结论上述疾病按常规方法治疗无效和反复检查仍查不到致病菌时，应警惕少见的眼部机会感染的可能，必须做特殊检查（棘阿米巴、厌氧菌培养、真菌血液培养、巨细胞病毒血清学检测等），才能明确诊断。     

紫外线-核黄素光动力疗法对眼科常见致病细菌的体外杀菌作用

背景 金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌是眼科的常见致病菌,研究最佳杀菌方法对眼科的临床工作具有重要意义. 目的 观察紫外线-核黄素光动力疗法（PDT）对眼科常见致病细菌的体外杀菌作用. 方法 分别取金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌冻存菌各10株接种于血培养皿中,复活2次培养至对数生长期后刮取菌落,置于细菌稀释液中,制备0.5麦氏浓度的细菌悬液原液,原液稀释10倍用于PDT实验.分别用1、2、3 mW/cm2紫外线A（UVA）对不同质量分数核黄素作用后的细菌照射10、20、30 min,测量不同条件下抑菌圈直径的大小,确定最佳抑菌条件.将金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌分别分为正常对照组、单独核黄素作用组、单独紫外线照射组和PDT组,比较不同组间各种细菌菌落数的差异. 结果 当UVA强度为3 mW/cm2、作用30 min、核黄素质量分数为0.1％时,MH固体培养皿上抑菌圈直径接近6 mm,故上述参数为PDT法抑菌的最佳条件.正常对照组、单独核黄素作用组、单独紫外线照射组和PDT组的金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌的菌落数依次减少,差异均有统计学意义（F=110.990、190.841、118.197,均P=0.000）,单独紫外线照射组各种细菌的菌落数均明显少于正常对照组,差异均有统计学意义（t=14.640、7.550、5.320,P＜0.05）,PDT组各种细菌的菌落数亦明显少于正常对照组的菌落数,差异均有统计学意义（t=25.480、14.750、12.920,P＜0.05）.单独紫外线照射组细菌量较正常对照组降低46.4％～50.2％,PDT组的细菌量降低91.6％ ～96.7％,而单独核黄素作用组的细菌菌落数与正常对照组相比差异均无统计学意义（t=0.660、0.470、0.510,P＞0.05）.结论 在紫外线-核黄素PDT灭活微生物的最佳体外实验条件下,PDT法对金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌的杀菌效果最好.     

细菌性角膜溃疡的医院流行病学，诱因和微生物诊断

目的：确定细菌性角膜溃疡的发病诱因,临床和微生物特性。 方法：本研究涉及300例（300眼）临床上疑似微生物感染的角膜溃疡患者。通过病史回顾和裂隙灯检查获得病例资料。采用标准技术完成角膜刮片检查。取部分刮片样本加入100g／h的氢氧化钾液后,以及采用革兰氏和吉姆萨染色,再直接在显微镜下观察是否存在真菌、细菌和棘阿米巴。另一部分刮片样本直接接种在血琼脂、麦康基琼脂、巧克力琼脂和萨布罗琼脂表面。通过角膜刮片检查,细菌性角膜溃疡被确诊为化脓性角膜溃疡浸润和表层上皮细胞缺失伴细菌感染。对患者应用抗菌治疗。 结果：在随访期间,因丢失而被排除的有60个病例。在剩下的240人中,被确诊为细菌性角膜溃疡的156人（65％）,大多数为男性（102眼）,年龄分布14—74岁。角膜溃疡位于角膜中央的96人（61．5％）,位于外周的60人（38．5％）。溃疡深度〈1／3角膜厚度的82人（52．6％）。前房炎症为：Tyndall现象和浮游细胞^1＋-2＋64人。角膜涂片中分离出细菌的有125人（80％）,其中69％为革兰氏阳性,39％为革兰氏阴性。革兰氏阴性菌感染患者伴有重症前房炎症（P=0．003）并且深度〉2／3角膜厚度（P=0．001）。分离得到的最常见致病微生物为金黄色葡萄球菌。治疗后40％的患者视力恢复到入院时的水平甚至更好,其余60％的患者预后差。 结论：细菌性角膜溃疡是一种严重的眼部感染性疾病,对眼部存在视力威胁,在治疗上仍具挑战性。快速分离细菌和眼部抗生素的应用是治疗此类疾病的关键。     

睑缘炎患者眼表微生物检测及相关临床分析

目的 探讨睑缘炎患者眼表微生物分布特征,分析睑缘炎抗菌治疗的疗效。设计 回顾性病例系列。研究对象 收集2015年2-9 月间在北京同仁医院眼科门诊临床诊断为睑缘炎的101例患者（101眼,睑缘炎组）,正常志愿者85例（85眼,对照组）。方法 在睑缘炎和对照组患者的结膜囊、睑缘及睑板腺分别取材,做细菌、厌氧菌和真菌培养,对培养阳性的菌株进行鉴定,分析两组眼表菌群差异特征。进一步将睑缘炎患者分为抗菌组和非抗菌组,治疗前及治疗2周后分别对症状体征评分,并进行眼表微生物检测,分析疗效及细菌检测结果。主要指标 眼表细菌检测结果、血平皿菌落计数及睑缘炎的眼部症状及体征评分。结果 睑缘炎组睑板腺细菌培养阳性率为62%,而对照组为53%（P=0.015）;睑缘炎组和对照组睑板腺厌氧培养阳性率分别为19%和45%,差异有统计学意义（P<0.001）。睑缘炎组与对照组睑缘细菌阳性率分别是71%和76%（P=0.533）,结膜囊细菌阳性率分别是48%和67%,两组间无统计学差异（P=0.062）。睑缘炎组睑缘、结膜囊及睑板腺血平皿菌落数量的均值均分别是（15.78±5.25）个、（13.62±6.27）个、（16.54±4.56）个, 对照组分别为（6.13±3.40）个、（4.75±3.82）个、（5.83±2.55）个,差异均有统计学意义（P均<0.001）。睑缘炎患者睑缘、结膜囊及睑板腺的培养菌群主要是革兰阳性球菌（构成比分别为：78.31%、71.15%和77.03%） ,与正常志愿者无差异（构成比分别为：76.71%、82.14%和76.74%）。睑缘炎组结膜囊和睑板腺革兰阳性球菌中,葡萄球菌属的阳性率（81%和88%）要低于正常对照组（96%和100%）,差异有统计学意义（P=0.034和0.036）。抗菌组和非抗菌组治疗2周后睑缘的除菌率分别为44%和21%,且两组的症状及体征的差异也有统计学意义（P=0.034和P=0.012）。结论 睑缘炎患者与正常人相比,眼表细菌阳性率无差异,但眼表带菌量要高于正常人,且革兰阳性球菌菌群构成不同,而睑板腺的厌氧菌带菌量要低于正常人;抗菌治疗可减少眼表带菌量,并改善患者眼表症状及体征。（眼科,2016,25： 118-122）     

氟喹诺酮药物的眼部表皮葡萄球菌防耐药突变浓度的测定

目的探讨氟喹诺酮药物对眼部分离的表皮葡萄球菌的防耐药突变浓度(MPC),并比较MPC与最低抑菌浓度(MIC)的关系。方法采用标准琼脂二倍稀释法测定表皮葡萄球菌对环丙沙星(CIP)、氧氟沙星(OFL)、左氧氟沙星(LVF)及加替沙星(GTF)的MIC值。挑选血液琼脂培养基上表皮葡萄球菌菌落,置于MullerHinton肉汤(MH)中增菌,菌液浓度至1×108cfu/ml,1∶10稀释,每种药每个浓度MullerHinton琼脂培养基(MHA)上接种1μl菌液,菌接种量104cfu。采用混菌法测定MPC值。以上述各种药物对该菌群的MIC50为参考,选择测定MPC时的药物浓度。每平皿中加入1ml药液和19ml细菌与MHA的混悬液,最终菌接种量约1010cfu。结果GTF的MIC90最低,为0.25mg/L;LVF次之,为0.50mg/L;CIP和OFLMIC90相等,为1.00mg/L。GTF对表皮葡萄球菌的MPC50和MPC90最低,分别是1.00mg/L和2.00mg/L;其次是LVF和CIP,均分别为2.00mg/L和4.00mg/L;OFL的MPC50和MPC90分别是2.00mg/L和8.00mg/L。结论LVF和GTF不仅抗菌作用强,而且在预防表皮葡萄球菌耐药突变方面有着明显的优势。(中华眼科杂志,2006,42989-991)     

0.01%次氯酸在白内障超声乳化术前应用的安全性和有效性

目的:评估0.01%次氯酸作为白内障超声乳化术前结膜囊消毒剂的效果和对眼表的影响。方法:随机对照临床试验。285例单眼拟行白内障超声乳化手术的患者随机分为次氯酸组和聚维酮碘组,在消毒前后取结膜囊拭子,使用血琼脂培养基和巧克力琼脂培养基分别进行细菌培养和菌落形成能力(CFUs)测试。所有患者在消毒后2 h, 1 d和1 wk接受眼部症状评分、疼痛程度评分的评估,并行角膜荧光素染色、眼红指数、泪河高度和非接触式泪膜破裂时间(NIBUT)检查,记录术后眼内炎的发生率。结果:使用0.01%次氯酸进行结膜囊消毒可显著降低细菌培养阳性率和CFUs,与消毒前相比有差异(均P<0.01),次氯酸消毒能力与聚维酮碘相当(χ²=0.811,P=0.368)。次氯酸组患者眼部症状评分和疼痛程度评分显著低于聚维酮碘组(均P<0.01)。次氯酸组角膜荧光素染色评分、眼红指数均显著低于聚维酮碘组(均P<0.01)。两组患者均无眼内炎发生。结论:0.01%次氯酸作为结膜囊消毒剂安全有效,且患者的不适和对眼表的损伤较小。     

多重聚合酶链反应快速诊断感染性眼内炎的研究

目的 探讨多重聚合酶链反应（MPCR）快速诊断细菌性、真菌性眼内炎及混合感染的价值。 方法 MPCR法检测常见致病性细菌和真菌菌株，并检测38例患者41只眼（双眼3例，单眼35例）眼内液标本，与细菌和真菌培养结果比较。 结果 MPCR法5 h即可检测出标本中微量细菌和真菌，41份标本MPCR检测阳性34份（82.9％），其中细菌阳性26份，真菌阳性6份，细菌和真菌均为阳性2份，MPCR阳性率明显高于细菌或真菌培养 （χ2＝9.60,P＜0.05）。 结论 MPCR速度快、敏感性和特异性高，有助于细菌性和真菌性眼内炎的快速明确诊断。 （中华眼底病杂志，2004，20：81-83）     

原发性泪小管炎119例诊治体会及病原学特征分析

目的：探讨原发性泪小管炎的临床特征、诊疗经验以及病原微生物的分布特征，为原发性泪小管炎的诊治提供一定的参考。方法：回顾性临床研究。纳入2019-06/2023-02期间在无锡市第二人民医院眼科诊断为原发性泪小管炎119例120眼。治疗方法主要分为保守治疗(经泪点清除泪小管结石联合管内注入抗生素眼膏)和手术治疗。病原微生物检查方法包括分泌物涂片镜检和微生物培养。结果：原发性泪小管炎多见于中老年女性，主要表现为长期眼红、分泌物增多，但多不伴有流泪症状。118例(99.2%)单眼发病，下泪小管发病63例63眼(52.5%)。实验室检查：119例120眼中有4例4眼未行实验室检查，余115例116眼检查结果如下：分泌物涂片革兰染色镜检，102例103眼(88.8%)检出放线菌，真菌涂片均为阴性； 微生物培养，85例86眼(74.1%)细菌培养阳性。共培养出111株细菌，26种菌株。其中需氧菌32株(28.8%)，厌氧菌26株(23.4%)，兼性厌氧菌53株(47.7%)。最常见菌种为：链球菌20株，葡萄球菌13株，丙酸杆菌和二氧化碳嗜纤维菌各10株。放线菌仅4例4眼(3.4%)培养阳性，真菌培养均为阴性。治疗情况：119例120眼中，114例115眼(95.8%)通过保守治疗经泪点清除泪小管结石联合管内注入抗生素眼膏(微创治疗方法，IOI)后痊愈，5例5眼保守治疗效果不佳，接受手术治疗后均达到治愈，总的治愈率100.0%。结论：原发泪小管炎发病率低，好发于中老年女性，单眼下泪小管多见，临床易漏诊误诊，放线菌为主要致病菌，多为混合感染，菌种异质，厌氧或兼性厌氧菌为主，链球菌、葡萄球菌最为常见。真菌性泪小管炎罕见。泪小管炎确诊后治愈率高，推荐IOI法作为泪小管炎初始治疗。     

Evaluation of the new OxyPlateTMAnaerobic System for the isolation of ocular anaerobic bacteria

AIM: Anaerobic bacteria can cause ocular infections. We tested the OxyPlate? Anaerobic System (OXY) to isolate pertinent anaerobic bacteria that can cause ocular disease.METHODS: OXY, which does not require direct anaerobic conditions (i.e. bags, jars), was compared to conventional isolation of incubating culture media in anaerobic bags. Standard colonies counts were performed on anaerobic ocular bacterial isolates under aerobic and anaerobic conditions (anaerobic bags) using agar media: 1) OXY (aerobic only), 2) 5% sheep blood (SB), 3) Chocolate, and 4) Schaedler. The bacteria tested were de-identified ocular isolates cultured from endophthalmitis and dacryocystitis that include 10 Propionibacterium acnes and 3 Actinomyces species. The colony counts for each bacteria isolate, on each culturing condition, were ranked from largest to smallest, and non-parametrically compared to determine the best culturing condition.RESULTS: All anaerobic conditions were positive for all of the anaerobic isolates. SB and Schaedler’s agar under aerobic conditions did not support the growth of anaerobic bacteria. Sparse growth was noted on chocolate agar with Propionibacterium acnes. As an anaerobic system, SB in an anaerobic bag isolated higher colony counts than OXY (P=0.0028) and chocolate agar (P=0.0028).CONCLUSION: Although OXY did not test to be more efficient than other anaerobic systems, it appears to be a reasonable alternative for isolating anaerobic bacteria from ocular sites. The use of an agar medium in a specially designed plate, without the requirement of an anaerobic bag, rendered OXY as an advantage over other anaerobic systems.     

An in Vitro Experimental Study on the Antimicrobial Activity of Silicone Oil against Anaerobic Bacteria

Purpose: To investigate the in vitro antimicrobial activity of silicone oil against anaerobic agents, specifically Propionibacterium acnes, Peptostreptococcus spp., Peptostreptococcus anaerobius, Bacteroides fragilis, Fuobacterium spp., and Clostridium tertium.

Method: A 0.5 McFarland turbidity of Propionibacterium acnes, Peptostreptococcus spp., Peptostreptococcus anaerobius, Bacteroides fragilis, Fuobacterium spp., and Clostridium tertium was prepared, and 0.1?mL was inoculated into 0.9?mL of silicone oil. Control inoculations were performed in anaerobic blood agar and fluid thioglycollate medium without silicone oil.

Results: Propionibacterium acnes retained their viability on the 3rd day in the presence of silicone oil. In total, 9.7?×?10⁶ colonies were enumerated from 1?mL of silicone oil. After a prolonged incubation of 7 days, the number of colonies observed was 9.2?×?10⁶. The other bacteria disappeared after the 3rd day of incubation in silicone oil.

Conclusions: Propionibacterium acnes, which is the most common chronic postoperative endophthalmitis agent, is thought to be resistant to silicone oil.     

Ocular Infections Due to Anaerobic Bacteria

The increased recovery of anaerobic bacteria in clinical infection has led to greater appreciation of these organisms in ocular infections. In studies that employed adequate method for recovery of anaerobes they were isolated from about a third of patients with conjunctivitis, half of the time in pure culture. The predominant recovered anaerobes were Clostridium spp., Gram-negative anaerobic bacilli, and Peptostreptococcus spp. Anaerobic bacteria were also recovered from patients who wore contact lenses and developed conjunctivitis. Anaerobic bacteria were also reported in cases of keratitis. The most frequently recovered anaerobes were Propionibacterium spp., Peptostreptococcus spp., Clostridium spp., Prevotella spp., and Fusobacterium spp. The most frequently recovered anaerobes from dacryocystitis were Peptostreptococcus spp., Propionibacterium spp., Prevotella spp., and Fusobacterium spp. This review describes the microbiology, diagnosis and management of ocular infections due to anaerobic bacteria in children.     

Conjunctival anaerobic and aerobic bacterial flora in paediatric versus adult subjects.

Although the bacterial flora of the conjunctiva in children and adults has been studied, there has been no previous comparison between these two age groups of anaerobic as well as aerobic bacteria. Conjunctival cultures from 229 eyes of 144 uninfected subjects were analysed for aerobic, microaerophilic, and anaerobic bacteria. Adults showed a greater number of species per eye than did younger subjects (1.47 versus 1.13; p less than 0.05). Anaerobic species, predominantly Propionibacterium, were obtained from 27.1% of all eyes, but from a significantly greater percentage (30.2% versus 12.8%) of adults' than children's eyes (p less than 0.04). Streptococcus spp. were cultured from 14.9% of the children's eyes as opposed to only 2.2% from adults (p less than 0.005). Understanding the differences in conjunctival flora between normal adults and children aids the interpretation of culture results and leads to properly defining and treating potential pathogens.     

High Prevalence of Biofilm-Forming MRSA in the Conjunctival Flora in Chronic Dacryocystitis

Objectives: To report the microbiological spectrum of conjunctival flora and prevalence of biofilm-forming Methicillin-resistant Staphylococcus aureus (MRSA) in conjunctival flora in chronic dacryocystitis.

Design: Prospective, case-control study.

Methods: We included patients with unilateral chronic dacryocystitis, and their unaffected eyes as control. Microbiological profile and antibiotic susceptibility of the isolates was determined by standard microbiological procedures. S. aureus isolates were further evaluated for Methicillin resistance by Oxacillin resistance screening agar method and mecA polymerase chain reaction (PCR) and for biofilm synthesis by Congo red agar method, Microtitre plate (MTP) assay, and ica A and ica D PCR.

Results: We found 95 patients with unilateral chronic dacryocystitis. Aerobic Gram-positive isolates (74.2%, n = 72) were more than Gram-negative (25.7%, n = 25) or anaerobic isolates (20.5%, n = 25). S. aureus was most common (46.4%, n = 45), followed by Pseudomonas aeruginosa (10.3%, n = 10). Gram-positive isolates showed highest sensitivity to Linezolid (100%) and higher generation fluoroquinolones. Gram-negative isolates showed good sensitivity (>90%) to all tested antibiotics. S. aureus isolates showed MRSA prevalence as 93.5% and 96.9% by Oxacillin resistance screening agar method and mecA PCR, respectively. Biofilm formation was found in 71.8% MRSA isolates by MTP assay and 58.1% MRSA isolates were resistant to ≥3 classes of antibiotics.

Conclusions: Gram-positive organisms, specifically S. aureus, are the major etiological agent in chronic dacryocystitis. There is high prevalence of MRSA in these isolates and concurrent biofilm formation.     

Bacteriological profile of ocular surface flora in meibomian gland dysfunction

Purpose

To compare the bacteriological profile of meibomian gland secretion and conjunctival cul-de-sac in subjects with and without meibomian gland dysfunction (MGD).

Colonization of the conjunctiva with Propionibacterium acnes before and after application of polyvidone iodine before intraocular surgery

Background: Propionibacterium acnes has been described as a causative agent of postoperative endophthalmitis. This gram-positive, immotile, non-spore-forming bacterium is highly pleomorphic and grows under conditions of low to no oxygen concentration. It is commonly found on the skin at the openings of sebaceous glands and on hairs. A near-symptomless postoperative endophthalmitis occurs particularly when Propionibacteria are enclosed in the capsular bag. We investigated to what extent the number of P. acnes in the conjunctival sac can be reduced by preoperative disinfection with polyvidone iodine (1 %). Patients and methods: A total of 261 patients with intrabulbar surgery had two conjunctival swabs taken: the first immediately prior to preoperative preparation in the operating theatre, following in-patient application of antibiotic eye drops (Polymyxin-B-sulfat, Neomycinsulfat and Gramicidin in combination); the second swab was taken after disinfection with polyvidone iodine before opening the conjunctiva. Results: Of the 261 swabs, 60 (23 %) taken prior to polyvidone iodine application were positive for Propionibacterium acnes. Following polyvidone iodine treatment, a further 5 (1.9 %) remained culture-positive. After disinfection, 55 (92 %) of the 60 positive swabs for Propionibacterium acnes remained culture-negative. Conclusions: We concluded that a significant reduction of P. acnes can be achieved by preoperative application of polyvidone iodine (1 %) (P < 0.001).      

Changing Bacterial Isolates and Antibiotic Sensitivities of Purulent Dacryocystitis

OBJECTIVE: To examine the current spectrum of bacterial isolates in cases of chronic dacryocystitis and dacryoabcess and to determine their antibiotic sensitivities. MATERIALS AND METHODS: We carried out a prospective study in which 39 patients who presented to the outpatient clinic with chronic purulent dacryocystitis or acute dacryoabscess had cultures taken. All patients were antibiotic-free for at least one week prior to culturing. RESULTS: The 39 positive cultures grew 41 bacterial isolates, as two patients grew two species of bacteria; 16 isolates (39%) were Gram-positive and 25 (61%) were Gram-negative. The most common isolates were Pseudomonas (22%), Staphylococcus aureus (13%), Enterobacter (10%), Citrobacter (10%), Streptococcus pneumoniae, E. coli, and Enterococcus (7%). Uncommon Gram-negative bacteria were also cultured: Alcaligenes in two cases (5%), and one case of Stenotrophomonas maltophilia (2.5%). No anaerobic bacteria were isolated. Gram-negative isolates were sensitive to ceftazidime in 95%, ciproxin in 86%, and cefuroxime in 50% of cases, with sensitivity of less than 30% to cephalexin and ampicillin in those tested. All Pseudomonas isolates (100%) were sensitive to ceftazidine, 86% were sensitive to ciprofloxacin, with only 20% being sensitive to ampicillin and 14% to cephalexin. Alcaligenes was resistant to all antibiotics tested with the exception of ceftazidine. CONCLUSION: This study demonstrates a significant change in bacterial flora and antibiotic treatment requirements of purulent dacryocystitis from previously published data. A higher incidence of Gram-negative organisms, particularly Pseudomonas, with resistance to commonly used antibiotics was found. The emergence of rarer highly resistant Gram-negative microorganisms may also indicate a trend in lacrimal sac infections. These findings suggest that the antibiotic treatment protocol before and after lacrimal surgery should be reconsidered in this subgroup of patients.     

巩膜扣带术对眼球部分结构参数的影响

目的：研究巩膜扣带术治疗孔源性视网膜脱离对眼球结构参数的影响。

方法：回顾性非随机临床病例研究。收集行巩膜扣带术治疗孔源性视网膜脱离的患者23例46眼的临床资料纳入研究,分析手术眼和对侧非手术眼术后3mo后复查时的最佳矫正视力、屈光度、眼压、前房深度、角膜内皮细胞计数、眼轴长度、眼球突出度等参数。

结果：本研究中所有患者行巩膜扣带术均一次性达到视网膜完全复位,无明显并发症及不良反应发生。至末次随访,与非手术眼相比,术眼屈光度、眼压、角膜内皮细胞计数、眼轴长度差异均无统计学意义(P>0.05),最佳矫正视力、前房深度、眼球突出度差异均有统计学意义(P<0.05)。

结论：巩膜扣带术对孔源性视网膜脱离有效,其对眼球前房深度、眼球突出度均产生了一定程度的影响。