Ophthalmic Antibiotic Use and Multidrug-Resistant Staphylococcus epidermidis A Controlled, Longitudinal Study
Ophthalmic Antibiotic Use and Multidrug-Resistant Staphylococcus epidermidis A Controlled, Longitudinal Study
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DOI：
10.1016/j.ophtha.2011.03.017
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发表时间：
2011-10-01
期刊：
影响因子：
13.7
通讯作者：
Kim, Stephen J.
中科院分区：
文献类型：
--
作者：
Dave, Sarita B.;Toma, Hassanain S.;Kim, Stephen J.
目的：分析结膜局部大环内酯类药物或氟喹诺酮类抗生素反复暴露后出现多药耐药表皮葡萄球菌的情况。设计：前瞻性、对照、纵向研究，随访1年。研究对象：24例(48眼)连续单侧玻璃体内注射脉络膜新生血管的患者。方法：连续4个月单侧玻璃体内注射，然后根据需要进行治疗。每个受试者被随机分配到4种抗生素(阿奇霉素1%，加替沙星0.3%，莫西沙星0.5%，氧氟沙星0.3%)中的一种，每次注射后只使用分配给他们的抗生素。分别在基线和每次注射后采集治疗组和未治疗组(对照组)的结膜培养标本。用Kirby-Bauer纸片扩散法检测所有细菌对16种不同抗生素的敏感性。主要观察指标：表皮葡萄球菌的药敏情况和多重耐药情况。结果：连续4次治疗后，从对照眼和治疗眼各分离出58株表皮葡萄球菌。对照眼分离的表皮葡萄球菌对3种或3种以上抗生素的耐药率为69%，治疗眼为90%(P
Purpose: To analyze the emergence of multidrug-resistant Staphylococcus epidermidis after repeated conjunctival exposure to topical macrolide or fluoroquinolone antibiotics.Design: Prospective, controlled, longitudinal study with 1-year follow-up.Participants: Forty-eight eyes of 24 patients undergoing serial unilateral intravitreal (IVT) injections for choroidal neovascularization.Methods: Subjects received 4 consecutive monthly unilateral IVT injections and then were treated as needed. Each subject was assigned randomly to 1 of 4 antibiotics (azithromycin 1%, gatifloxacin 0.3%, moxifloxacin 0.5%, ofloxacin 0.3%) and used only their assigned antibiotic after each injection. Conjunctival culture specimens of the treated and untreated fellow eye (control) were obtained at baseline and after each injection. All bacterial isolates were tested for antibiotic susceptibility to 16 different antibiotics using the Kirby-Bauer disc diffusion technique.Main Outcome Measures: Antibiotic susceptibility patterns and multidrug resistance of S. epidermidis.Results: After 4 consecutive treatments, a total of 58 isolates of S. epidermidis each were isolated from control and treated eyes. Resistance to 3 or more antibiotics was present in 69% of S. epidermidis isolated from control eyes compared with 90% from treated eyes (P