【摘要】：目的分析病原學診斷為細菌性角膜炎患者的臨床特征、病原菌分布、藥物敏感性及疾病轉歸。設計回顧性病例系列。研究對象2010年1月至2015年4月北京同仁醫(yī)院細菌培養(yǎng)陽性的角膜炎患者146例。方法對患者的臨床病歷資料統(tǒng)計分析臨床特征、病原菌分布以及藥物敏感試驗結果等。主要指標患者一般情況、臨床特征、治療及轉歸,以及細菌培養(yǎng)和藥敏試驗結果。結果 146例均為單眼患病。平均年齡(46.7±18.97)歲,女性64例(43.84%)。眼外傷病史46例(31.5%)。76例(52.1%)就診前使用過局部抗菌素類藥物,19例(13.0%)使用過局部糖皮質激素類藥物,15例(10.3%)聯(lián)合使用了抗生素和糖皮質激素類藥物;病原菌82例(56.2%)為革蘭陽性菌、64例(43.8%)為革蘭陰性菌。假單胞菌(34.9%)最常見,其次為葡萄球菌(24.0%)。病原菌對加替沙星、阿米卡星和左氧氟沙星類藥物具有較高敏感性。139眼(95.2%)局部用藥治療病情好轉或治愈;7眼(4.8%)行手術治療。結論眼外傷是細菌性角膜炎最常見的危險因素;革蘭陽性菌為較常見的病原菌類型,病原菌對加替沙星、阿米卡星和左氧氟沙星具較高敏感性,藥物控制不良時需積極采取手術治療。
[Abstract]:Objective to analyze the clinical characteristics, pathogen distribution, drug sensitivity and disease outcome of patients with bacterial keratitis diagnosed by etiology. A retrospective series of cases was designed. From January 2010 to April 2015, 146 patients with keratitis with positive bacterial culture in Beijing Tongren Hospital were enrolled in the study. Methods the clinical characteristics, pathogen distribution and drug sensitivity test results were statistically analyzed. Main outcome measures: general condition, clinical characteristics, treatment and prognosis, bacterial culture and drug sensitivity test results. Results 146 cases were monocular diseases. The average age was (46.7 鹵18.97) years, 64 cases (43.84%) were female. 46 cases (31.5%) had history of ocular trauma. 76 cases (52.1%) had been treated with local antibiotics and 19 cases (13.0%) had been treated with local glucocorticoids. 15 cases (10.3%) were treated with antibiotics and glucocorticoids. 82 cases (56.2%) were Gram-positive bacteria and 64 cases (43.8%) were Gram-negative bacteria. Pseudomonas (34.9%) was the most common, followed by Staphylococcus (24.0%). The pathogen was highly sensitive to gatifloxacin, amikacin and levofloxacin. 139 eyes (95.2%) were treated with local drugs for improvement or cure, and 7 eyes (4.8%) were treated surgically. Conclusion Eye trauma is the most common risk factor for bacterial keratitis. Gram-positive bacteria are common pathogenic bacteria. Gram-positive bacteria are highly sensitive to gatifloxacin, amikacin and levofloxacin. Surgical treatment should be taken actively when drug control is poor.
【作者單位】： 首都醫(yī)科大學附屬北京朝陽醫(yī)院眼科;首都醫(yī)科大學附屬北京同仁醫(yī)院北京同仁眼科中心北京市眼科研究所眼科學與視覺科學北京市重點實驗室;
【分類號】：R772.21

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