Causative organisms of post-traumatic endophthalmitis: a 20-year retrospective study.
Causative organisms of post-traumatic endophthalmitis: a 20-year retrospective study.
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DOI：
10.1186/1471-2415-14-34
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发表时间：
2014-03-25
影响因子：
2
通讯作者：
Lin X
中科院分区：
文献类型：
--
作者：
Long C;Liu B;Xu C;Jing Y;Yuan Z;Lin X
眼外伤后进入眼内的各种微生物可引起眼内炎。本研究旨在探讨外伤性眼内炎患者的病原菌谱及细菌药敏情况。对912例在中国三级眼科中心接受治疗的外伤性眼内炎患者进行了回顾性研究。危险因素与最常见的分离微生物之间的关系采用卡方检验。采用卡方检验比较了前10年（1990-1999年）和后10年（2000-2009年）的发病率。p < 0.05被认为具有统计学显著性。347例（38.1%）眼内炎培养阳性，11例（3.2%）显示混合感染（革兰阴性杆菌和真菌），共产生358种微生物病原体。培养证实的微生物包括革兰阳性球菌150株（41.9%），革兰阴性杆菌104株（29.1%），革兰阳性杆菌44株（12.3%），真菌60株（16.8%）。凝固酶阴性葡萄球菌（CNS）种S。epidermidis（21.8%）和S.主要病原菌为嗜盐芽孢杆菌（12.0%）、枯草芽孢杆菌（8.7%）、铜绿假单胞菌（7.8%）和大肠埃希菌（6.4%）。CNS培养阳性与术后24 h以上的延迟修复（p < 0.001）和金属损伤（p < 0.01）显著相关。最常见的真菌种类是曲霉菌（26/60），其次是酵母样真菌（18/60）。铜绿假单胞菌对环丙沙星、头孢哌酮、妥布霉素、头孢呋辛和头孢他啶的敏感率分别为83.3%、75%、75%和75%。革兰阴性菌占优势，且存在多重耐药。我们鉴定了引起创伤后眼内炎的广谱微生物，其中革兰氏阳性球菌是最常见的致病微生物，其次是芽孢杆菌属、真菌和混合感染。CNS感染与延迟修复和金属损伤在统计学上相关。不同时期分离的细菌对抗生素的敏感性存在差异。环丙沙星和头孢他啶分别在研究的第一和第二个十年中显示出对细菌性创伤后眼内炎的最高活性。根据第二个十年的数据，对于铜绿假单胞菌引起的感染，环丙沙星、妥布霉素和头孢菌素之一的联合治疗可能提供最佳覆盖率。
A wide range of organisms that enter the eye following ocular trauma can cause endophthalmitis. This study was to investigate the spectrum of pathogens and antibiotic susceptibility of bacterial isolates from a large cohort of post-traumatic endophthalmitis cases. A retrospective study of 912 post-traumatic endophthalmitis patients treated at a tertiary eye-care center in China was performed. The associations between risk factors and the most common isolated organisms were investigated by Chi square Test. The percent susceptibilities for the first 10 years (1990–1999) and the second 10 years (2000–2009) were compared by Chi square test. p < 0.05 was considered statistically significant. Three-hundred-forty-seven (38.1%) cases of endophthalmitis were culture-positive, and 11 (3.2%) showed mixed infections (Gram-negative bacilli and fungi), yielding a total of 358 microbial pathogens. Culture proven organisms included 150 (41.9%) Gram-positive cocci, 104 (29.1%) Gram-negative bacilli, 44 (12.3%) Gram-positive bacilli, and 60 (16.8%) fungi. The coagulase-negative staphylococcal (CNS) species S. epidermidis (21.8%) and S. saprophyticus (12.0%) were the predominant pathogens, followed by Bacillus subtilis (8.7%), Pseudomonas aeruginosa (7.8%), and Escherichia coli (6.4%). Delayed repair over 24 h (p < 0.001) and metallic injury (p < 0.01) were significantly associated with positive culture of CNS. The most frequent fungal species were Aspergillus (26/60), followed by yeast-like fungi (18/60). P. aeruginosa was relatively sensitive to ciprofloxacin (83.3%), cefoperazone (75%), tobramycin (75%), cefuroxime (75%), and ceftazidime (75%) during the second decade. Multi-drug resistance was observed in the predominant Gram-negative bacteria. We identified a broad spectrum of microbes causing post-traumatic endophthalmitis, with Gram-positive cocci the most frequently identified causative organism, followed by Bacillus species, fungi, and mixed infections. CNS infection was statistically associated with delayed repair and metallic injury. Variation in antibiotic susceptibility was observed among isolated bacteria and between different periods. Ciprofloxacin and ceftazidime in the first and second decades of the study, respectively, showed the highest activity against bacterial post-traumatic endophthalmitis. For infections caused by P. aeruginosa, a combination therapy of ciprofloxacin, tobramycin, and one of the cephalosporins might provide optimal coverage according to data from the second decade.
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DOI：
10.1097/01.iae.0000225072.68265.ee
发表时间：
2007-02-01
影响因子：
3.3
作者：
Al-Omran, Abdulrahman M.;Abboud, Emad B.;Abu El-Asrar, Ahmed M.
通讯作者：
Abu El-Asrar, Ahmed M.
影响因子：
13.7
作者：
Essex, RW;Yi, Q;Allen, PJ
通讯作者：
Allen, PJ
影响因子：
3.4
作者：
Cornut, Pierre-Loic;Youssef, El Bichara;Chiquet, Christophe
通讯作者：
Chiquet, Christophe
影响因子：
3.9
作者：
Gupta, A.;Srinivasan, R.;Saha, I.
通讯作者：
Saha, I.
影响因子：
2.9
作者：
Jindal, Animesh;Moreker, Mayur R.;Flynn, Harry W., Jr.
通讯作者：
Flynn, Harry W., Jr.