中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
12期
1480-1482
,共3页
何梅凤%吴伟%周家豪%唐细兰
何梅鳳%吳偉%週傢豪%唐細蘭
하매봉%오위%주가호%당세란
角膜炎%细菌感染%真菌感染%病原西%耐药性
角膜炎%細菌感染%真菌感染%病原西%耐藥性
각막염%세균감염%진균감염%병원서%내약성
Keratitis%Bacterial infection%Fungal infection%Pathogen%Durg resistance
目的 了解我中心感染性角膜炎细菌及真菌分布、变迁及耐药情况,为临床合理治疗提供依据.方法 收集中山眼科中心2004年至2010年2046例角膜感染患者微生物实验室检查资料,对细菌和真菌培养的阳性率、菌属的分布及耐药性进行回顾性分析.结果 2046份标本中,培养阳性的标本1022份,阳性率为49.9％,其中只有细菌的标本463份(包括11份培养出2种细菌的标本),只有真菌的标本500份,同时有细菌及真菌的标本59份.细菌以革兰阳性球菌为主,336株(占63.0％),其次为革兰阴性杆菌,163株(占30.6％),其中表皮葡萄球菌最多,257株(占48.2％),其次为铜绿假单胞菌,84株(占15.8％)；真菌以镰刀菌属最多,180株(占32.2％),其次为曲霉菌属和蠕孢菌属,分别为139株(占24.9％)和110株(占19.7％).细菌分布近7年变化不明显,真菌中蠕孢菌属近7年有明显上升趋势,而曲霉菌属总体呈下降趋势.主要致病细菌表皮葡萄球菌对氨基糖苷类抗菌药的敏感性相对较好,而铜绿假单胞菌则对喹诺酮类相对较敏感.结论 广东地区角膜感染主要致病细菌为表皮葡萄球菌,对新霉素较敏感,主要致病真菌为镰刀菌属,蠕孢菌属检出的升高及曲霉菌属的下降趋势应引起临床的关注.
目的 瞭解我中心感染性角膜炎細菌及真菌分佈、變遷及耐藥情況,為臨床閤理治療提供依據.方法 收集中山眼科中心2004年至2010年2046例角膜感染患者微生物實驗室檢查資料,對細菌和真菌培養的暘性率、菌屬的分佈及耐藥性進行迴顧性分析.結果 2046份標本中,培養暘性的標本1022份,暘性率為49.9％,其中隻有細菌的標本463份(包括11份培養齣2種細菌的標本),隻有真菌的標本500份,同時有細菌及真菌的標本59份.細菌以革蘭暘性毬菌為主,336株(佔63.0％),其次為革蘭陰性桿菌,163株(佔30.6％),其中錶皮葡萄毬菌最多,257株(佔48.2％),其次為銅綠假單胞菌,84株(佔15.8％)；真菌以鐮刀菌屬最多,180株(佔32.2％),其次為麯黴菌屬和蠕孢菌屬,分彆為139株(佔24.9％)和110株(佔19.7％).細菌分佈近7年變化不明顯,真菌中蠕孢菌屬近7年有明顯上升趨勢,而麯黴菌屬總體呈下降趨勢.主要緻病細菌錶皮葡萄毬菌對氨基糖苷類抗菌藥的敏感性相對較好,而銅綠假單胞菌則對喹諾酮類相對較敏感.結論 廣東地區角膜感染主要緻病細菌為錶皮葡萄毬菌,對新黴素較敏感,主要緻病真菌為鐮刀菌屬,蠕孢菌屬檢齣的升高及麯黴菌屬的下降趨勢應引起臨床的關註.
목적 료해아중심감염성각막염세균급진균분포、변천급내약정황,위림상합리치료제공의거.방법 수집중산안과중심2004년지2010년2046례각막감염환자미생물실험실검사자료,대세균화진균배양적양성솔、균속적분포급내약성진행회고성분석.결과 2046빈표본중,배양양성적표본1022빈,양성솔위49.9％,기중지유세균적표본463빈(포괄11빈배양출2충세균적표본),지유진균적표본500빈,동시유세균급진균적표본59빈.세균이혁란양성구균위주,336주(점63.0％),기차위혁란음성간균,163주(점30.6％),기중표피포도구균최다,257주(점48.2％),기차위동록가단포균,84주(점15.8％)；진균이렴도균속최다,180주(점32.2％),기차위곡매균속화연포균속,분별위139주(점24.9％)화110주(점19.7％).세균분포근7년변화불명현,진균중연포균속근7년유명현상승추세,이곡매균속총체정하강추세.주요치병세균표피포도구균대안기당감류항균약적민감성상대교호,이동록가단포균칙대규낙동류상대교민감.결론 엄동지구각막감염주요치병세균위표피포도구균,대신매소교민감,주요치병진균위렴도균속,연포균속검출적승고급곡매균속적하강추세응인기림상적관주.
Objective To analyze the distribution and shifting trends of pathogens causing bacterial or fungal keratitis and their resistance to commonly used antibiotics in Zhongshan ophthalmic center.Methods Two thousend and forty-six specimens from patients with infective keratitis from January 2004 to December 2010 were collected.Bacterial and fungal culture-positive rate,the genus distribution of isolates and resistance regularity to antibiotics were analyzed retrospectively.Results Out of 2046 specimens,1022 were positive cultures,showing a positive rate of 49.9％.Of those individuals with positive cultures,463 had pure bacterial infection ( including 11 specimens with two bacterial growth),500 had pure fungal infection and 59 had mixed growth.The predominant bacterial pathogens isolated were Gram-positive cocci ( 336 of 533,63.0％ ) and Gram-negative bacilli ( 163 of 533,30.6％ ),in which Staphylococcus epi(257 of 533,48.2％ )was the most common pathogen,followed by Pseudomonas aeruginosa(84 of 533,15.76％ ).The predominant fungal pathogens isolated was Fusarium.Spp.( 180 of 559,32.2％ ),followed by Aspergillus Spp.(139 of 559,24.9％ )and Helminthosporium( 110 of 559,19.7％ ).The distribution of pathogens causing bacterial keratitis had no significant change.However,there has been an increase in Helminthosporium and a decrease in Aspergillus Spp.Overall,aminoglycosides showed better sensitivity to Staphylococcus epi,and fluoroquinolones had a better sensitivity to Pseudomonas aeruginosa.Conclusions In the area of Guangdong,the most common pathogens of bacterial keratitis was Staphylococcus epi,which showing highest sensitivity to neomycin,and Fusarium Spp are the predominant pathogens of fungal keratitis.The increased recovery of Helminthosporium and decreased recovery of Aspergillus Spp.from keratitis isolates presents an important challenge to the ophthalmology.
