江门地区老年性白内障患者结膜囊带菌状况的调查
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摘要
目的:了解江门地区50岁以上老年性白内障患者结膜囊带菌状况,分析细菌构成和对药物的敏感性。方法:选择2016年6-10月在本院住院的50岁以上的老年性白内障患者707例1414眼,在结膜囊无菌化准备前,采集结膜囊标本做细菌培养及药敏试验。结果:送检1414份标本中,有菌生长106眼(7.5%),其中91眼(6.4%)有细菌生长,15眼(1.1%)有真菌生长。不同性别、眼别、年龄,结膜囊细菌检出率比较,差异均无统计学意义(P>0.05)。不同月份、不同居住地的结膜囊细菌检出率比较,差异均有统计学意义(P<0.05)。阳性标本中各菌种的构成比为,G~+球菌75.5%(80/106),G~+杆菌7.5%(8/106),G-~杆菌1.9%(2/106),G~-球菌0.9%(1/106),真菌14.2%(15/106)。药物敏感试验结果显示,大多数G~+球菌对克林霉素、妥布霉素、万古霉素敏感,对林可霉素和诺氟沙星耐药。整体而言,万古霉素、左氧氟沙星的耐药率较低。结论:江门地区50岁以上老年性白内障患者结膜囊可能带有病原菌,并以G~+球菌为主。大多数细菌对万古霉素和耐药的左氧氟沙星敏感。
Objective:To analyze the situation of conjunctival sac carrier in patients over 50 years old with senile cataract in the area of Jiangmen Method:A total of 707 patients of 1414 eyes with senile cataract aged over 50 years who admitted to our hospital from June to October in 2016 were selected. Before the preparation of conjunctival sac, specimens of conjunctival sac were collected for bacterial culture and drug sensitivity test.Result:Among 1414 pieces of inspected specimens, 106 eyes(7.5%) were bacterial growth.Among them, 91 eyes(6.4%) were bacterial growth bacteria and 15 eyes(1.1%) were fungal growth.There had no significant differences in the comparison regarding different sex,eyes,ages,and the detection rate of conjunctival sac bacteria(P>0.05).The bacterial detection rate of conjunctival sac in different months and different places were statistically significant(P<0.05).The constituent ratios of different bacteria in the positive samples were G+ cocci 75.5%(80/106),G~+ bacillus 7.5%(8/106),G~-bacillus 1.9%(2/106),G~-cocci 0.9%(1/106),and fungi 14.2%(15/106).It can be seen from the drug sensitivity test that most G~+ coccus was sensitive to Clindamycin,Tobramycin,and Vancomycin and most G~+ coccus was drug resistive to Lincomycin and Norfloxacin.Overall,the rates of drug resistance to Vancomycin and Levofloxacin were low.Conclusion:Pathogenic bacteria may be found in conjunctiva sacs among patients with senile catarace aged over 50 years in Jiangmeng District.The dominant bacteria are G~+ coccus.Most of bacterias are sensitive to Vancomycin and Levofloxacin.
Objective:To analyze the situation of conjunctival sac carrier in patients over 50 years old with senile cataract in the area of Jiangmen Method:A total of 707 patients of 1414 eyes with senile cataract aged over 50 years who admitted to our hospital from June to October in 2016 were selected. Before the preparation of conjunctival sac, specimens of conjunctival sac were collected for bacterial culture and drug sensitivity test.Result:Among 1414 pieces of inspected specimens, 106 eyes(7.5%) were bacterial growth.Among them, 91 eyes(6.4%) were bacterial growth bacteria and 15 eyes(1.1%) were fungal growth.There had no significant differences in the comparison regarding different sex,eyes,ages,and the detection rate of conjunctival sac bacteria(P>0.05).The bacterial detection rate of conjunctival sac in different months and different places were statistically significant(P<0.05).The constituent ratios of different bacteria in the positive samples were G+ cocci 75.5%(80/106),G~+ bacillus 7.5%(8/106),G~-bacillus 1.9%(2/106),G~-cocci 0.9%(1/106),and fungi 14.2%(15/106).It can be seen from the drug sensitivity test that most G~+ coccus was sensitive to Clindamycin,Tobramycin,and Vancomycin and most G~+ coccus was drug resistive to Lincomycin and Norfloxacin.Overall,the rates of drug resistance to Vancomycin and Levofloxacin were low.Conclusion:Pathogenic bacteria may be found in conjunctiva sacs among patients with senile catarace aged over 50 years in Jiangmeng District.The dominant bacteria are G~+ coccus.Most of bacterias are sensitive to Vancomycin and Levofloxacin.
引文
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[14]宋林,姚春华,尚丽霞,等.哈萨克族中老年人结膜囊带菌情况调查分析[J].中华眼外伤职业眼病杂志,2015,37(1):59-61.
[15]石明华,胡楠.术后眼内炎及其预防的研究进展[J].眼科新进展,2006,26(9):716-719.
[16]张小平,叶剑.近13年中国人结膜囊细菌培养结果文献回顾与相关调查因素的Meta分析[J].中国实用眼科杂志,2005,23(4):428-431.
[17]夏桂兰,栾洁.正常结膜囊带菌情况分析[J].东南大学学报(医学版),2010,29(5):535-538.
[18]宋林,姚春华,魏文斌,等.新疆哈萨克族白内障患者术前结膜囊细菌培养及药敏试验分析[J].国际眼科杂志,2015,15(3):528-530.
[19]杨砚亭,卢国华.应用抗菌药物降低结膜囊细菌量的临床研究[J].中国感染控制杂志,2014,13(11):674-676.
[20]黄怀洁,牛梅民,杨怡,等.白内障围术期用药与术后感染相关性探讨[J].中国医药导报,2014,11(1):52-54.
[2]朱力,沈念慈,陈华洁,等.老年人内炎手术前结膜囊细菌培养的分析[J].眼外伤职业眼病杂志,2004,26(3):156-158.
[3]刘静,谢汉平,吴力克,等.重庆市不同年龄健康人结膜囊需氧菌定性及定量研究[J].第三军医大学学报,2009,31(10):682-688.
[4]刘治容,张悦,董万江,等.羌族中老年人结膜囊细菌状况调查[J].实用医院临床杂志,2010,7(5):60-62.
[5]陆琼,周佳.白内障术前结膜囊细菌培养及药物敏感性[J].临床眼科杂志,2013,21(6):530-531.
[6]胡继发,欧阳文博,邓坤明,等.结膜囊成形术治疗结膜囊缩窄70例临床分析[J].中华眼外伤职业眼病杂志,2016,38(1):42-44.
[7]徐欢欢,程莹莹,赵长霖,等.中国白内障人群术前结膜囊细菌培养结果的Meta分析[J].国际眼科杂志,2014,14(1):100-102.
[8]聂昕,谯雁彬,陈西嘉,等.糖尿病并发白内障患者手术前后结膜囊菌群分析[J].中华医院感染学杂志,2016,26(5):1064-1066.
[9]刘梦阳,孙士营,曾庆延.结膜囊正常菌群与眼部细菌感染的关系[J].中国感染与化疗杂志,2007,7(1):48-52.
[10]许立军,王一,伍宛苏,等.1100眼白内障术前结膜囊细菌培养分析[J].第三军医大学学报,1996,18(4):93-94.
[11]曹奎,张悦,董万江,等.绵阳市中老年人结膜囊细菌状况调查分析[J].四川医学,2010,31(8):1042-1044.
[12]郑红,张悦,多吉,等.甘孜州彝族中老年人结膜囊细菌状况调查[J].实用医院临床杂志,2011,8(5):70-72.
[13]孙士营,翟华蕾,谢立信.白内障术前结膜囊细菌培养结果及药敏变化[J].中国实用眼科杂志,2005,23(5):509-513.
[14]宋林,姚春华,尚丽霞,等.哈萨克族中老年人结膜囊带菌情况调查分析[J].中华眼外伤职业眼病杂志,2015,37(1):59-61.
[15]石明华,胡楠.术后眼内炎及其预防的研究进展[J].眼科新进展,2006,26(9):716-719.
[16]张小平,叶剑.近13年中国人结膜囊细菌培养结果文献回顾与相关调查因素的Meta分析[J].中国实用眼科杂志,2005,23(4):428-431.
[17]夏桂兰,栾洁.正常结膜囊带菌情况分析[J].东南大学学报(医学版),2010,29(5):535-538.
[18]宋林,姚春华,魏文斌,等.新疆哈萨克族白内障患者术前结膜囊细菌培养及药敏试验分析[J].国际眼科杂志,2015,15(3):528-530.
[19]杨砚亭,卢国华.应用抗菌药物降低结膜囊细菌量的临床研究[J].中国感染控制杂志,2014,13(11):674-676.
[20]黄怀洁,牛梅民,杨怡,等.白内障围术期用药与术后感染相关性探讨[J].中国医药导报,2014,11(1):52-54.