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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年02期

页码:

175-177,187

栏目:

临床医学

出版日期:

2020-04-30

文章信息/Info

Title:

Effect of gentamicin in irrigating solutions on bacteria in conjunctival sac of cataract patient

文章编号:

1006-8147(2020)02-0178-05

作者:

马文江; 王俊妨; 侯光华; 孙鹏; 李春艳

（天津医科大学眼科医院检验科，天津300384）

Author(s):

MA Wen-jiang;  WANG Jun-fang;  HOU Guang-hua;  SUN Peng;  LI Chun-yan

（Clinical Laboratory of Tianjin Medical University Eye Hospital，Tianjin 300384, China）

关键词:

灌注液; 庆大霉素; 白内障; 眼内炎; 左氧氟沙星

Keywords:

irrigating solutions;  gentamicin;  cataract;  endophthalmitis;  levofloxacin

分类号:

R776.1

DOI:

-

文献标志码:

A

摘要:

目的：分析白内障手术灌注液中庆大霉素对白内障患者结膜囊细菌的作用，为制定围手术期眼内炎预防措施提供依据。方法：采集200例白内障患者结膜囊拭子标本，进行细菌培养鉴定和药物敏感试验，观察检出细菌对20 μg/mL、40 μg/mL、80 μg/mL庆大霉素和2 μg/mL左氧氟沙星敏感率。结果：结膜囊细菌培养阳性检出率为62%，其中以表皮葡萄球菌为主，耐甲氧西林金黄色葡萄球菌（MRSA）检出率为3.22%，耐甲氧西林表皮葡萄球菌（MRSE）检出率为28.2%；全部检出细菌对20 μg/mL、40 μg/mL、80 μg/mL庆大霉素和2 μg/mL左氧氟沙星敏感率分别为79.84%、95.16%、97.58%、78.23%，中高浓度庆大霉素和左氧氟沙星比较，差异有统计学意义（均P<0.05）；MRSA和MRSE对20 μg/mL、40 μg/mL、80 μg/mL庆大霉素和2 μg/mL左氧氟沙星敏感率分别为69.23%、94.87%、100%、41.03%，各浓度庆大霉素和左氧氟沙星比较，差异有统计学意义（均P<0.05）。结论：白内障患者结膜囊细菌对灌注液中庆大霉素具有较高的敏感度，灌注液中加入适宜浓度庆大霉素，作为白内障围手术期眼内炎预防的措施应继续加以推广。

Abstract:

Objective: To analyze the effect of gentamicin in cataract irrigating solutions on bacteria in conjunctival sac of cataract patient and to provide the evidence for endophthalmitis precaution in cataract perioperative period. Methods: Bacterial culture and drug sensitive test were performed for 200 samples from cataract patients’ conjunctival sac. Susceptibility rates of detected pathogens against 20 μg/mL, 40 μg/mL, 80 μg/mL gentamicin and 2 μg/mL levofloxacin were observed. Results: Cultural positive rate of conjunctival sac was 62% (mainly Staphylococcus epidermidis, among them MRSA 3.22%, MRSE 28.2%). The sensitivity rates of all detected bacteria to 20 μg/mL, 40 μg/mL, 80 μg/mL gentamicin and 2 μg/mL levofloxacin were 79.84%, 95.16%, 97.58%, 78.23%, respectively. The difference between high and medium concentrations of gentamicin and levofloxacin was statistically significant(all P<0.05). The sensitivity rates of MRSA and MRSE to 20 μg/mL, 40 μg/mL, 80 μg/mL gentamicin and 2 μg/mL levofloxacin were 69.23%, 94.87%, 100%, 41.03%, respectively. The difference between gentamicin in each concentration and levofloxacin was statistically significant(all P<0.05). Conclusion: The bacteria in the conjunctival sac of patients with cataract have a high sensitivity to gentamicin in irrigating solutions. Gentamycin at appropriate concentration in irrigating solutions is a good measure for perioperative endophthalmitis prevention during cataract surgery.

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备注/Memo

备注/Memo:

作者简介 马文江（1974-），男，副主任技师，博士，研究方向：感染性眼病实验室诊断和临床微生物学；E-mail:mwj707@sohu.com。

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更新日期/Last Update: 2020-06-02