Ophthalmic Antibiotic Resistance Study

描述：(申请者摘要)微生物角膜炎是一种常见的、 经济上重要的眼病，尽管有可用的 抗菌治疗，会降低视力和生活质量。一位少校 尚未解决的问题是微生物学实验室在指导中的作用 决策。这项先导性研究的目标是使用临床和 角膜微生物感染患者的微生物学数据 确定抗菌素耐药性如何影响结果。使用回顾 队列研究设计，本次流行病学调查将检验其效果 初始抗生素治疗的适宜性和体外试验 角膜分离株对视力、抗生素使用时间的敏感性分析 治疗，以及需要手术的眼部并发症。多变量 Logistic回归和比例风险分析将控制 潜在的混杂因素(包括人口统计变量、病程、 严重程度参数和辅助治疗)，并将考虑可能的影响 改良剂(如微生物分类和最低抑菌浓度) 确定调整后的相对效果指标。由此衍生出的知识 研究对视力研究和临床有潜在的很大影响 实践，并有可能指导更广泛的调查 医院感染的耐药性问题及抗生素的合理使用 眼科。

DESCRIPTION: (Applicant's Abstract) Microbial keratitis is a common, economically important ocular disease that, despite the availability of antimicrobial therapy, can reduce vision and the quality of life. A major unresolved issue is the role of the microbiology laboratory in guiding decision-making. The goal of this pilot research is to use clinical and microbiologic data from patients who have had microbial corneal infection to determine how antimicrobial resistance affects outcome. Using a retrospective cohort study design, this epidemiological investigation will examine the effect of the appropriateness of initial antibiotic therapy and the in vitro susceptibility profile of corneal isolates on vision, length of antibiotic treatment, and ocular complications requiring surgery. Multivariable logistic-regression and proportional-hazards analyses will control for potential confounders (including demographic variables, disease duration, severity parameters, and adjunctive therapy) and will consider possible effect modifiers (such as microbial taxonomy and minimal inhibitory concentration) to determine adjusted relative effect measures. The knowledge derived from this research has a potentially high impact on vision research and on clinical practice and has the potential to direct broader investigations into the problem of antimicrobial resistance and the optimal use of antibiotics in ophthalmology.