感染性眼内炎致病原因及病原菌分布

目的 了解感染性眼内炎的致病原因、病原菌分布及耐药情况。方法 回顾性分析2016年1月-2018年12月某院病历系统中感染性眼内炎患者的临床资料。结果 90例感染性眼内炎主要由眼外伤所致（56.7%），20例（22.2%）由眼部手术后引起，其中19例（95.0%）为白内障手术合并人工晶状体植入术引起。52株感染性眼内炎致病菌中，革兰阳性菌占50.0%（26株），主要为表皮葡萄球菌（13株），革兰阴性菌占30.8%（16株），主要为铜绿假单胞菌（6株）、肺炎克雷伯菌（4株）。表皮葡萄球菌对万古霉素、利奈唑胺、利福平、替加环素敏感率为100.0%，对青霉素及苯唑西林敏感率较低（<50%）。结论 感染性眼内炎多由眼外伤和眼部手术尤其是白内障手术引起，致病菌以表皮葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌为主。

Causes of infective endophthalmitis and distribution of pathogens

Objective To analyze disease causes, distribution and drug resistance of pathogens causing infective endophthalmitis(IE). Methods Clinical data of patients with IE in a hospital from January 2016 to December 2018 were retrospectively analyzed. Results 90 cases of IE were mainly caused by ocular trauma (56.7%), 20 (22.2%) were caused by eye surgery, 19 (95.0%) of which were caused by cataract surgery combined with artificial lens implantation. Among 52 strains of pathogens causing IE, Gram-positive bacteria accounted for 50.0% (26 strains), mainly Staphylococcus epidermidis (13 strains), Gram-negative bacteria accounted for 30.8% (16 strains), mainly Pseudomonas aeruginosa (6 strains) and Klebsiella pneumoniae (4 strains). Susceptibility rates of Staphylococcus epidermidis to vancomycin, linezolid, rifampicin and tigecycline were all 100.0%, while susceptibility rates to penicillin and oxacillin were both low (< 50%). Conclusion IE is mainly caused by ocular trauma and eye surgery, especially cataract surgery, the main pathogens are Staphylococcus epidermidis, Pseudomonas aeruginosa and Klebsiella pneumoniae.