摘要
目的:探究年龄相关性白内障手术后发生感染性眼内炎的病原学特点及相关因素与预防。方法:回顾性分析本院2016-01/2018-01收治的1 365例年龄相关性白内障患者,统计患者感染性眼内炎发生情况,并分析感染性眼内炎病原学特点及相关危险因素。结果:患者28例发生感染性眼内炎,共检出病原菌36株,其中表皮葡萄球菌9株(25.00%),铜绿假单胞菌9株(25.00%),芽孢杆菌8株(22.22%)。铜绿假单胞菌、芽孢杆菌对头孢唑林、头孢噻肟、阿莫西林具有较强的耐药性;对头孢哌酮-舒巴坦、美罗培南的敏感性较高;表皮葡萄球菌对青霉素、红霉素、阿奇霉素有较强的耐药性,对万古霉素、呋喃妥因、米诺环素的敏感性较高。Logistic多因素回归分析,年龄(≥70岁)、糖尿病、手术时间(≥15min)、术中玻璃体溢出是年龄相关性白内障术后发生感染性眼内炎的独立危险因素(P<0.05)。结论:年龄相关性白内障手术后感染性眼内炎病原菌以表皮葡萄球菌、铜绿假单胞菌、芽孢杆菌多见。年龄(≥70岁)、糖尿病、手术时间(≥15min)、术中玻璃体溢出为年龄相关性白内障手术后发生感染性眼内炎的独立危险因素。
AIM:To explore the etiology,related factors and prevention of infectious endophthalmitis after age-related cataract surgery.METHODS:A retrospective analysis of 1 365 age-related cataract patients admitted to our hospital from 2016-01/2018-01,statistics of the incidence of infectious endophthalmitis,and analysis of the pathogenic characteristics of infectious endophthalmitis and related risk factors.RESULTS:Infective endophthalmitis occurred in 28 patients,and 36 pathogens were detected,including 9 strains of staphylococcus epidermidis(25.00%),9 strains of pseudomonas aeruginosa(25.00%),and 8 strains of bacillus(22.22%).Pseudomonas aeruginosa and Bacillus have strong resistance to cefazolin,cefotaxime and amoxicillin;high sensitivity to cefoperazone-sulbactam and meropenem;staphylococcus to epidermidis erythromycin and azithromycin have strong drug resistance,and have high sensitivity to vancomycin,nitrofurantoin and minocycline.Multivariate regression analysis of Logistic,age(≥70 years),diabetes,operative time(≥15min),intraoperative vitreous spillover were independent risk factors for infectious endophthalmitis after age-related cataract surgery(P<0.05).CONCLUSION:Infectious endophthalmitis pathogens after age-related cataract surgery are more common with Staphylococcus epidermidis,Pseudomonas aeruginosa,and Bacillus.Age(≥70 years),diabetes,operative time(≥15min),intraoperative vitreous spillover were independent risk factors for infectious endophthalmitis after age-related cataract surgery.
作者
刘铁
解成志
谢同朴
Tie Liu;Cheng-Zhi Xie;Tong-Pu Xie(Department of Ophthalmology,the 465 Hospital Affiliated to Jilin Medical College,Jilin 132013,Jilin Province,China;Department of Ophthalmology,the Hospital of Chinese People's Liberation Army 94333 Force,Weifang 261051,Shandong Province,China)
出处
《国际眼科杂志》
CAS
北大核心
2019年第10期1764-1767,共4页
International Eye Science
关键词
白内障
感染性眼内炎
老年
病原学
影响因素
cataract
infectious endophthalmitis
elderly
etiology
influencing factors
