摘要
目的探讨内眼手术前患眼结膜囊细菌对眼科常用抗生素的敏感性及耐药菌株的产生与患者全身免疫状况与眼睑、结膜病变的关系。方法手术前根据患者全身免疫状况及眼睑和结膜的表现确定有无全身或局部危险因素。在用任何抗生素之前采集结膜囊标本做培养、鉴定和药物敏感性试验。对5种及5种以上的抗生素耐药的菌株称为多重耐药菌株(MR)。结果在110例(110眼)中,有全身危险因素者51例,其中带有MR者27例(52.94%),与无全身危险因素(59例)而带MR者(15例,25.42%)相比差异有统计学意义(P=0.003);有局部危险因素者47例,其中带有MR者23例(48.94%),与无局部危险因素(63例)而带MR者(17例,26.98%)相比差异有统计学意义(P=0.018);既有全身又有局部危险因素者22例,其中带有MR者14例(63.64%),与既无全身又无局部危险因素(34例)而带MR者(7例,20.59%)相比差异有统计学意义(P=0.001)。结论带有全身或/和局部危险因素的患者眼表细菌的耐药性强,对这类特殊人群加强预防措施是必要的。
Objective To investigate the drug-sensitivity of conjunctival bacteria before intraocular surcery, and the relationship between the conjunctival bacterial flora resistant to multiple antibiotics and the systemic immune state, eyelids and conjunctival abnormality of the patients. Methods Patients with systemic or local risk factors were defined according to their immune states and the appearance of their eyelids and conjunctiva. Conjunctival cultures were obtained prior to preoperative antibiotics and povidone-iodine. Bacteria isolated were identified and antibiotic susceptibility was determined. Bacteria resistant to five or more antibiotics were defined as multi-resistant （MR）. Results Among the 110 patients （110 eyes） enrolled in the study, 51 patients had systemic factors and among them 27 patients （52.94%） carried MR organisms, compared to 15 of the 59 patients （25.42%） without systemic risk factors （P = 0. 003 ）. 47 patients had local risk factors and among them 23 patients （48.94%） carried MR organisms,compared to 17 of the 63 patients （26.98%） without local risk factors （P =0.018）. 14 of 22 patients （63.64%） who had both local and systemic risk factors carried MR organisms, compared to 7 of the 34 patients （ 20.59% ） with neither loeal nor systemic risk factors （ P = 0.001 ）. Conclusion Patients with local and/or systemic risk factors are more likely to harbor MR organisms. Reinforcement the prophylactic measures is necessary in these patients.
出处
《眼外伤职业眼病杂志》
北大核心
2008年第11期846-848,共3页
Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries
关键词
结膜囊细菌
耐药性
危险因素
conjunctival bacterial flora
drug-resistance
risk factor
作者简介
胡楠（1965-），女，江苏无锡人。医学硕士，主任医师。E-mail：hunaneye@hotmail．com
