摘要
目的探讨我国东部地区江苏省南通市2家三级医院10年内拟诊为感染性角膜炎患者的眼部病原谱及药物敏感性特征。方法采用横断面研究,连续收集2014年1月至2023年10月在南通市第一人民医院、南通大学附属医院眼科收治的疑似感染性角膜炎患者1404例的微生物培养标本,分析患者一般资料、病原学及药物敏感性试验结果。结果1404例疑似感染性角膜炎患者中,微生物培养阳性率为37.04%(520/1404)。共计分离培养537菌株,真菌占69.09%(371/537),细菌占30.91%(166/537)。真菌性角膜炎中常见菌属为镰刀菌属(占47.17%,175/371)、链格孢属(占15.90%,59/371)、曲霉菌属(占14.56%,54/371)、赛多孢菌属(占10.78%,40/371)和青霉菌属(占3.50%,13/371),镰刀菌属的年度构成比呈下降趋势,赛多孢菌属呈上升趋势。细菌性角膜炎中常见细菌为表皮葡萄球菌(占24.10%,40/166)、肺炎链球菌(占17.47%,29/166)、铜绿假单胞菌(占13.25%,22/166)、金黄色葡萄球菌(占6.63%,11/166)和麦金利棒状杆菌(占4.22%,7/166),铜绿假单胞菌的年度构成比呈上升趋势。革兰阳性球菌对左氧氟沙星和万古霉素的耐药率分别为36.26%和0%,革兰阴性杆菌对氨基糖苷类和头孢他啶的耐药率均<10%。共计61株(占40.94%)细菌为多重耐药菌。结论真菌性角膜炎中以镰刀菌属常见,细菌性角膜炎中麦金利棒状杆菌可能是南通市的微生物特征;左氧氟沙星可能不再适合作为眼局部使用的一线抗生素。
Objective To investigate the ocular pathogen spectrum and drug sensitivity characteristics of patients to be diagnosed with infectious keratitis within 10 years in two tertiary hospitals in Nantong City,Jiangsu Province,eastern China.Methods A cross-sectional study was conducted.Microbial culture specimens from consecutive 1404 patients with suspected infectious keratitis admitted to the Department of Ophthalmology at the First People's Hospital of Nantong City and Nantong University Affiliated Hospital from January 2014 to October 2023 were collected.The patients'general data,etiology and drug sensitivity test results were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Nantong First People's Hospital(No.2021KT273)and Nantong University Affiliated Hospital(No.2019-K068).Results Among 1404 patients with suspected infectious keratitis,the positive rate of microbial culture was 37.04%(520/1404).A total of 537 strains were isolated and cultured,with fungi accounting for 69.09%(371/537)and bacteria accounting for 30.91%(166/537).The common bacterial genera in fungal keratitis were Fusarium(47.17%,175/371),Alternaria(15.90%,59/371),Aspergillus(14.56%,54/371),Certospora(10.78%,40/371)and Penicillium(3.50%,13/371).The annual composition ratio of Fusarium showed a downward trend,while Certospora showed an upward trend.The common bacteria in bacterial keratitis were Staphylococcus epidermidis(24.10%,40/166),Streptococcus pneumoniae(17.47%,29/166),Pseudomonas aeruginosa(13.25%,22/166),Staphylococcus aureus(6.63%,11/166)and Corynebacterium macginleyi(4.22%,7/166).The annual composition ratio of Pseudomonas aeruginosa showed an increasing trend.The resistance rates of gram-positive bacteria to levofloxacin and vancomycin were 36.26%and 0%respectively,and the resistance rates of gram-negative bacteria to aminoglycosides and ceftazidime were<10%.A total of 61 bacterial strains(40.94%)were multi-drug resistant.Conclusions Fusarium is common in fungal keratitis,and Corynebacterium macginleyi in bacterial keratitis may be a microbial feature in Nantong City.Levofloxacin may no longer be suitable as a first-line antibiotic for topical ocular use.
作者
李盼盼
管怀进
郭洋辰
蔡骐
朱妍
许慕东
王勇
Li Panpan;Guan Huaijin;Guo Yangchen;Cai Qi;Zhu Yan;Xu Mudong;Wang Yong(Department of Ophthalmology,Nantong First People's Hospital,Nantong 226001,China;Department of Ophthalmology,Nantong University Affiliated Hospital,Nantong 226001,China)
出处
《中华实验眼科杂志(中英文)》
北大核心
2025年第8期722-729,共8页
Chinese Journal Of Experimental Ophthalmology
基金
南通市卫生健康委员会科研课题(MSZ2024027)。
关键词
感染性角膜炎
细菌
真菌
多重耐药菌
Microbial keratitis
Bacteria
Fungus
Multi-drug resistant organism
作者简介
通信作者:王勇,Email:wangboai2@163.com。
