某医院2017—2018年眼科感染病原菌分布及耐药性分析
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摘要
目的分析佛山市第二人民医院眼科诊治感染患者的病原菌菌株分布情况及耐药性,了解眼科主要致病菌的耐药性。方法选择我院2017年1月—2018年12月眼科送检阳性病原菌培养样本共106例,分析眼科致病菌分布及耐药特征。结果 2017年共监测阳性标本56例,其中革兰阳性菌37例(66.0%),革兰阴性菌15例(26.7%),真菌4例(7.1%)。2018年共监测阳性标本50例,其中革兰阳性菌36例(72.0%),革兰阴性菌12例(24.0%),真菌2例(4.0%)。表皮葡萄球菌排在眼科革兰阳性致病菌的第1位。铜绿假单胞菌排在眼科革兰阴性致病菌的第1位。表皮葡萄球菌对苯唑西林、左氧氟沙星、四环素保持较高耐药率,对万古霉素具有较高敏感性。铜绿假单胞菌对亚胺培南和阿米卡星均有较高敏感性,对头孢吡肟、哌拉西林/他唑巴坦、左氧氟沙星有一定耐药现象。结论 2017—2018年我院眼科感染病原菌以革兰阳性菌为主,对万古霉素敏感,革兰阴性菌对左氧氟沙星有一定的耐药性。为预防术后感染发生,应严格术前消毒,依据药物敏感试验检测结果合理使用抗生素。
Objective To analyze the distribution of pathogenic bacteria and the trend of drug resistance in ophthalmic surgery in Foshan Second People's Hospital, and to understand the law of drug resistance change of major pathogenic bacteria in ophthalmology.Methods One hundred and six samples of positive pathogenic bacteria were selected from January 2017 to December 2018 in our hospital. The distribution and drug resistance of pathogenic bacteria in ophthalmology were analyzed. Results In 2017, 56 positive samples were monitored, including 37(66.0%) Gram-positive bacteria, 15(26.7%) Gram-negative bacteria and 4(7.1%) fungi. In 2018,50 positive samples were monitored, including 36(72.0%) Gram-positive bacteria, 12(24.0%) Gram-negative bacteria and 2(4.0%)fungi. Staphylococcus epidermidis ranked first among the Gram-positive pathogens in ophthalmology. Pseudomonas aeruginosa ranked first among Gram-negative pathogens in ophthalmology. Staphylococcus epidermidis maintained a high resistance rate to oxacillin, levofloxacin and tetracycline, and was highly sensitive to vancomycin. Pseudomonas aeruginosa was highly sensitive to imipenem and amikacin, and resistant to cefepime, piperacillin/tazobactam and levofloxacin. Conclusions Gram-positive bacteria are the main pathogenic bacteria in ophthalmic infections from 2017 to 2018, and the detection rate showes an increasing trend. Gram-negative bacteria are sensitive to vancomycin. Gram-negative bacteria are resistant to levofloxacin. In order to prevent postoperative infection, preoperative disinfection should be strictly carried out and antibiotics should be reasonably used according to the results of drug susceptibility test.
Objective To analyze the distribution of pathogenic bacteria and the trend of drug resistance in ophthalmic surgery in Foshan Second People's Hospital, and to understand the law of drug resistance change of major pathogenic bacteria in ophthalmology.Methods One hundred and six samples of positive pathogenic bacteria were selected from January 2017 to December 2018 in our hospital. The distribution and drug resistance of pathogenic bacteria in ophthalmology were analyzed. Results In 2017, 56 positive samples were monitored, including 37(66.0%) Gram-positive bacteria, 15(26.7%) Gram-negative bacteria and 4(7.1%) fungi. In 2018,50 positive samples were monitored, including 36(72.0%) Gram-positive bacteria, 12(24.0%) Gram-negative bacteria and 2(4.0%)fungi. Staphylococcus epidermidis ranked first among the Gram-positive pathogens in ophthalmology. Pseudomonas aeruginosa ranked first among Gram-negative pathogens in ophthalmology. Staphylococcus epidermidis maintained a high resistance rate to oxacillin, levofloxacin and tetracycline, and was highly sensitive to vancomycin. Pseudomonas aeruginosa was highly sensitive to imipenem and amikacin, and resistant to cefepime, piperacillin/tazobactam and levofloxacin. Conclusions Gram-positive bacteria are the main pathogenic bacteria in ophthalmic infections from 2017 to 2018, and the detection rate showes an increasing trend. Gram-negative bacteria are sensitive to vancomycin. Gram-negative bacteria are resistant to levofloxacin. In order to prevent postoperative infection, preoperative disinfection should be strictly carried out and antibiotics should be reasonably used according to the results of drug susceptibility test.
引文
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[3]张晓燕,张慧芝,陈梦平,等.某院2013—2016年抗菌药物眼用制剂使用量与眼部感染细菌耐药性分析[J].中国药房,2017,28(26):3634-3638.
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[7]鲁为凤,彭洁,曹勍,等.白内障术后患者发生感染性眼内炎的相关因素分析及围术期护理的预防效果研究[J].中华医院感染学杂志,2017,27(23):5437-5440.
[8]郭晓文,吴坤林,姜蕾.眼部感染病原菌对氨基糖苷类抗菌药物的耐药性研究[J].中华医院感染学杂志,2015,25(14):3210-3212.
[2]王彦方,俞颂平,施天严,等.感染性眼病患者感染病原菌分布与耐药性研究[J].中华医院感染学杂志,2018,28(6):907-910.
[3]张晓燕,张慧芝,陈梦平,等.某院2013—2016年抗菌药物眼用制剂使用量与眼部感染细菌耐药性分析[J].中国药房,2017,28(26):3634-3638.
[4]罗益文,万尚韬,蒋冬冬,等.白内障超声乳化摘除联合人工晶状体植入术后感染性眼内炎的相关因素分析[J].中华医院感染学杂志,2017,27(17):3978-3981.
[5]曹燕,赵俊宏,赵平,等.超声乳化白内障吸除术后发生感染性眼内炎的危险因素及防治措施研究[J].中华眼科医学杂志(电子版),2014,4(3):132-135.
[6]张阳,王智群,孙旭光. 2006至2015年我国北方地区细菌性角膜炎病原学及药物敏感性分析[J].中华眼科杂志,2017,9(53):662-667.
[7]鲁为凤,彭洁,曹勍,等.白内障术后患者发生感染性眼内炎的相关因素分析及围术期护理的预防效果研究[J].中华医院感染学杂志,2017,27(23):5437-5440.
[8]郭晓文,吴坤林,姜蕾.眼部感染病原菌对氨基糖苷类抗菌药物的耐药性研究[J].中华医院感染学杂志,2015,25(14):3210-3212.