Conjunctival bacterial flora and antimicrobial susceptibility in bacterial pathogens isolated prior to cataract surgery
Conjunctival bacterial flora and antimicrobial susceptibility in bacterial pathogens isolated prior to cataract surgery
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DOI：
10.1007/s10384-020-00746-z
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发表时间：
2020-07-01
影响因子：
2.4
通讯作者：
Shimizu, Yumiko
中科院分区：
文献类型：
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作者：
Matsuura, Kazuki;Miyazaki, Dai;Shimizu, Yumiko
目的了解白内障手术前眼部分离的细菌对抗生素的敏感性，以优化预防性应用抗生素。设计回顾性横断面研究。方法对102例204眼行常规双眼白内障手术的患者，术前1~2周采集结膜囊刮片。对分离出的470株细菌中的192株主要病原菌进行了药敏试验。主要病原菌包括金黄色葡萄球菌、表皮葡萄球菌、凝固酶阴性葡萄球菌等。表皮葡萄球菌、粪肠球菌和链球菌。检测了头孢甲肟(CMX)、头孢他啶(CAZ)、妥布霉素(TOB)、万古霉素(VAN)、红霉素(EM)、莫西沙星(MFLX)、加替沙星(GFLX)、左氧氟沙星(LVFX)、氯霉素(CP)和亚胺培南(IP)。结果OFS最低抑菌浓度(MIC)所占比例。82例表皮病变中，CAZ(95.1%)、EM(32.9%)、LVFX(39.0%)、CP(82.9%)阳性率较高。对CMX、VAN、CP和IP的易感(S)比例较高，分别为98.8%、100%、93.9%和97.6%，而甲氧氟沙星(59.8%)、格列环磷酰胺(54.9%)和左氟沙星(54.9%)的易感比例相对较低。最低抑菌浓度(MIC)值较高的有环丙沙星(16mU g/ml)、卡马西平()、TOB(32mU g/ml)、EM(128mU g/ml)、左旋氧氟沙星(16mU g/ml)和CP(8mU g/ml)。除表皮葡萄球菌(N=108)外，包括2株耐甲氧西林金黄色葡萄球菌在内的11株病原菌对喹诺酮类药物的最低抑菌浓度(MIC)均大于4微克/毫升。结论结膜囊内细菌对抗生素的耐药性增加，表明全身和外用抗生素已不再有效，尤其是对影响眼部的外部细菌。
Purpose To optimize prophylactic antibiotic administration, antibiotic susceptibility before cataract surgery was investigated using ocular bacteria isolated preoperatively. Design Retrospective cross-sectional study. Methods In 204 eyes of 102 patients who underwent routine bilateral cataract surgery, conjunctival sac scrapings were collected 1-2 weeks before surgery. A total of 192 major pathogens among the 470 isolated bacteria were subjected to susceptibility testing. The major pathogens includedStaphylococcus aureus,Staphylococcus epidermidis, coagulase-negative staphylococci (CNS) other thanS. epidermidis,Enterococcus faecalis, and Streptococcus spp. The following antibiotics were tested: cefmenoxime (CMX), ceftazidime (CAZ), tobramycin (TOB), vancomycin (VAN), erythromycin (EM), moxifloxacin (MFLX), gatifloxacin (GFLX), levofloxacin (LVFX), chloramphenicol (CP), and imipenem (IP). Results The proportions of isolates with minimum inhibitory concentration (MIC) ofS. epidermidis(N = 82), exceeding 4 mu g/ml were high for CAZ (95.1%), EM (32.9%), LVFX (39.0%), and CP (82.9%). Susceptible (S) proportion was high for CMX (98.8%), VAN (100%), CP (93.9%), and IP (97.6%) but relatively low for MFLX (59.8%), GFLX (54.9%), and LVFX (54.9%). The MIC(90)values were high for CMX (16 mu g/ml), CAZ (64 mu g/ml), TOB (32 mu g/ml), EM (128 mu g/ml), LVFX (16 mu g/ml), and CP (8 mu g/ml). The MIC of quinolonesof pathogenic bacteria other thanS.epidermidis(N = 108), exceeded 4 mu g/ml for 11 isolates, including two Methicillin-resistantStaphylococcus aureus. Conclusions The increase in resistance of resident bacteria present in the conjunctival sac to antibiotics indicates that systemic and topical antibiotics are no longer effective, especially against external organisms affecting the eye.