Trends in dacryocystitis in China: A STROBE-compliant article.
Trends in dacryocystitis in China: A STROBE-compliant article.
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中国泪囊炎的趋势符合STROBE标准的文章
DOI：
10.1097/md.0000000000011318
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发表时间：
2018-06
期刊：
影响因子：
1.6
通讯作者：
Hong J
中科院分区：
文献类型：
--
作者：
Chen L;Fu T;Gu H;Jie Y;Sun Z;Jiang D;Yu J;Zhu X;Xu J;Hong J
该研究的目的是回顾过去15年来中国泪囊炎患者中分离的细菌病原体的分布、当前趋势和微生物学特征。这是一个回顾性的多中心非比较病例系列。回顾了2002年至2016年期间来自7个城市的15452名连续诊断为泪囊炎的患者的医疗记录。回顾和分析患者的人口统计学、微生物学数据和抗生素敏感性。研究期间共采集泪囊内容物培养3344例（21.6%）。1996份样品中检出病原菌（59.7%），阳性培养物中细菌分离物1902株（95.3%）。检出革兰氏阳性菌1218株（61.0%），革兰氏阴性菌607株（30.4%），厌氧菌285株（14.3%）。在研究期间发现革兰氏阳性分离株增加（P = 0.003）。优势菌株为凝固酶阴性葡萄球菌（485株，25.5%）、金黄色葡萄球菌（186株，9.8%）、铜绿假单胞菌（184株，9.7%）和流感嗜血杆菌（152株，9.0%）。红霉素耐药呈上升趋势，前5年为10.5%，后5年为20.7% （P < 0.001）。药敏试验结果显示，加替沙星对大多数革兰氏阳性、革兰氏阴性和厌氧菌最有效。中国泪囊炎的微生物培养率较低。随着时间的推移，革兰氏阳性细菌的比例有所增加。与革兰氏阴性菌株相比，革兰氏阳性菌株对所测抗生素的敏感性相对较低。我们的数据显示，经验性使用第四代氟喹诺酮类药物治疗难治性泪囊炎可能是合理的。
Supplemental Digital Content is available in the text The aim of the study was to review the distribution, current trends, and microbiological characteristics of bacterial pathogens isolated from dacryocystitis patients in China during the last 15 years. This is a retrospective multiple-center noncomparative case series. The medical records of 15,452 consecutive patients from 7 cities diagnosed as having dacryocystitis between 2002 and 2016 were reviewed. The patients’ demographics, microbiological data, and antibiotic sensitivity were reviewed and analyzed. A total of 3344 lacrimal sac content cultures were taken (21.6%) during the study period. A pathogen was identified in 1996 samples (59.7%), with bacterial isolates accounting for 1902 of the positive cultures (95.3%). Gram-positive isolates, gram-negative isolates, and anaerobic bacteria were found in 1218 (61.0%), 607 (30.4%), and 285 (14.3%) samples, respectively. An increase in gram-positive isolates over the study duration was found (P = .003). The predominant isolates were coagulase negative Staphylococci (485, 25.5%), Staphylococcus aureus (186, 9.8%), Pseudomonas aeruginosa (184, 9.7%), and Haemophilus influenzae (152, 9.0%). There was a trend toward increasing resistance to erythromycin from 10.5% during the first 5 years of the study to 20.7% during the last 5 years (P < .001). Antimicrobial susceptibility testing showed that gatifloxacin was the most effective drug against most of gram-positive, gram-negative, and anaerobic bacteria. The microbial culture rate of dacryocystitis in China is low. There was an increase in the percentage of gram-positive bacteria over time. The sensitivity of gram-positive isolates to tested antibiotics is relatively low compared with that of gram-negative isolates. Our data show that the empiric use of fourth-generation fluoroquinolones in refractory dacryocystitis may be justified.