新生儿急性细菌性结膜炎10年致病菌变迁

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.

The transition of bacterial pathogens in acute neonatal conjunctivitis in recent 10 years

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.