急性细菌性结膜炎最新病原学分析

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。

Microbiological features of acute bacterial conjunctivitis

Objective To investigate the changes of bacterial spectrum in acute bacterial conjunctivitis in China. Methods Secretion specimens were taken from the inferior conjunctiva surface of 50 eyes of 50 patients with acute bacterial conjunctivitis. Gram ’ s stain and bacterial culture were done. After 5 days of administration of 10 g . L - l azithromycin eye drops , bacterial cultures were tested again 3 days later. Results Bacterial culture positive rate was 80. 0% . 97. 5 % of eyes showed Gram ’ s stain positive bacterium and most of them were staphylococcus epidermidis ( 72. 5% ) .including 2 cases with oxacillin-resistant Staphylococcus epidermidis. After 5 days of adnunistration of anti-biotics , clinical symptoms in 94. 0% of the patients were gone. In 60. 0% of the cases,the pathogenic bacteria were completely elinunated. while in 5. 0% of the cases. they were partly eliminated. Staphylococcus epidermidis was still the main bacterium in the re-test ( 56. 2% ) . Conclusion The most prevalent bacterium of acute bacterial conjunctivitis in China is staphylococcus epidermidis . in which more attentions should be paid and targeted treatment should be given.