长期局部广谱抗生素应用对结膜囊菌种变化的影响及意义

目的：通过观察长期局部广谱抗生素使用后结膜囊菌种培养的变化，揭示结膜囊菌群失调对于局部病原学变化的影响。方法选取连续使用喹诺酮类抗生素4周以上的非感染性角膜溃疡患者115例（115只眼），进行结膜囊病原学培养。120例（120只眼）正常人作为对照组。结果送检对照组标本中，共培养出10个菌种，102个菌株。葡萄球菌属最多共75株（62．5％％），其中表皮葡萄球菌23株（19．19％），金黄色葡萄球菌19株（15．83％）。实验组结膜囊葡萄球菌属培养阳性率明显下降，仅为16．67％，而痤疮丙酸杆菌阳性率增高到19.43％，铜绿假单胞菌阳性率3．15，酵母菌阳性率19．13％。结论长期局部广谱抗生素使用，可导致结膜囊菌群失调，条件致病菌特别是酵母菌增多。

The clinical impacts of long-term topical broad-spectrum antibiotics administration on conjunctiva cultured bacteria

Objective To investigate the effects of long-term topical use of broad-spectrum antibiotics on conjunc-tival sac flora disequilibrium and its association with focal pathogens.Methods One hundred fifteen patients who suffered from non-infectious corneal ulcer and who were chronically (>4 weeks) administrated with quinolone eye drops were en-rolled.One hundred twenty normal subjects served as the control.Results There were 10 specimens and 102 strains cul-tured from conjunctival sac in normal population.Majority of the identified strains in normal subjects were Staphylococcus ( n=75 strains; 62.5%) .These strains can be further classified into Staphylococcus epidermidis ( n =23 strains;19.19%) and Staphylococcus aureus ( n =19 strains;15.83%).In contrast, positive rate of Staphylococcus significantly decreased in patients with history of long-term antibiotic usage ( only 16.67%) .However, the positive rate for Propi-onibacterium acnes (19.34%), Pseudomonas aeruginosaincreased (3.15%) and yeast (19.13%) significantly in-creased.Conclusion Long-term use of topical broad-spectrum antibiotics can lead to conjunctival sac flora disequilibrium and increased opportunistic pathogens, especially yeast.