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目的分析化脓性眼内炎细菌培养的临床特征以及对药物的敏感度,为临床治疗化脓性眼内炎选择适合的抗菌药物提供科学依据。方法选取132例化脓性眼内炎患者,患者均行玻璃体切除术或玻璃体腔内注射药物,并于术前取玻璃体液作为样本进行细菌与真菌培养,分析培养的阳性菌株以及对药物敏感度的结果。结果 132例样本中,有70例样本培养出阳性菌株,阳性菌检出率为53.03%。70例阳性菌株中,有37例为革兰阳性菌,其中表皮葡萄球菌11例、铜绿假单胞菌9例、肠杆菌6例、变形杆菌5例、产碱杆菌3例、肺炎克雷伯菌3例,所占革兰阳性菌百分比分别为29.73%、24.32%、16.22%、13.51%、8.11%、8.11%。行药敏试验发现,环丙沙星、头孢哌酮、头孢唑啉以及妥布霉素对革兰阳性菌具有较高的敏感度(χ~2值分别为5.632、5.342、5.216、5.106,P<0.05),庆大霉素、新霉素、氯霉素等抗生素对革兰阳性菌的敏感度较低(P>0.05)。结论对化脓性眼内炎患者的玻璃体液进行细菌培养,能观察到患者的致病菌种类,且通过药敏试验能得出药物对患者致病菌的敏感情况,具有重要的现实意义。
Objective To analyze the clinical characteristics of bacterial culture of suppurative endophthalmitis and its sensitivity to drugs to provide a scientific basis for the selection of suitable antibacterial drugs for the treatment of suppurative endophthalmitis. Methods 132 patients with purulent endophthalmitis were selected. Patients underwent vitrectomy or intravitreal injection of vitreous humor. Vitreous fluid was taken before operation for bacterial and fungal culture. The positive strains cultured and their sensitivity to drugs result. Results Of the 132 samples, 70 samples were positive for the positive strains. The positive rate of positive bacteria was 53.03%. Of the 70 positive strains, 37 were Gram-positive bacteria, including 11 Staphylococcus epidermidis, 9 Pseudomonas aeruginosa, 6 Enterobacter, 5 Proteus, 3 Alcaligenes, Klebsiella pneumoniae Three strains of bacteria accounted for 29.73%, 24.32%, 16.22%, 13.51%, 8.11% and 8.11% respectively of Gram-positive bacteria. Drug susceptibility tests showed that ciprofloxacin, cefoperazone, cefazolin and tobramycin had higher sensitivity to Gram-positive bacteria (χ ~ 2 values were 5.632,5.342,5.216,5.106, P <0.05). Gentamicin, neomycin, chloramphenicol and other antibiotics were less sensitive to Gram-positive bacteria (P> 0.05). Conclusion Bacterial culture of vitreous humor in patients with suppurative endophthalmitis can be observed in patients with pathogenic bacteria, and through drug susceptibility tests can be obtained drug sensitivity of patients with pathogenic bacteria, has important practical significance.