| 胡俊敏,李 鸿,付 艳,郝 炜,刘 颖.白内障术后感染性眼内炎的致病菌分析及影响因素研究[J].,2021,(1):74-78 |
| 白内障术后感染性眼内炎的致病菌分析及影响因素研究 |
| Study on Pathogenic Bacteria and Influencing Factors of Infective Endophthalmitis after Cataract Surgery |
| 投稿时间：2020-05-20 修订日期：2020-06-14 |
| DOI：10.13241/j.cnki.pmb.2021.01.015 |
| 中文关键词: 白内障 术后 感染性眼内炎 致病菌 影响因素 |
| 英文关键词: Cataract Postoperative Infective endophthalmitis Pathogenic bacteria Influencing factors |
| 基金项目:北京市科技计划项目（D161100002918121） |
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| 中文摘要: |
| 摘要 目的：分析白内障术后感染性眼内炎的致病菌分布情况，并对其影响因素进行分析。方法：选取2016年8月~2019年3月期间于我院行白内障手术的患者2936例，统计白内障术后感染性眼内炎的发生情况。分析术后感染性眼内炎患者的病原菌分布情况及病原菌耐药情况。单因素及多因素Logistic回归分析术后感染性眼内炎发生的影响因素。结果：本研究中，共发放2936份调查问卷，回收2931份，回收率为99.83%（2931/2936）。其中53例患者患有感染性眼内炎，发生率为1.81%（53/2931），根据患者是否患有感染性眼内炎分为感染组（n=53）和未感染组（n=2878）。感染性眼内炎的病原菌检出41株，其中革兰阳性菌37株，占90.24％；共检出4株真菌，为白色假丝酵母菌，占比9.76%。37株革兰阳性菌中，头状葡萄球菌、表皮葡萄球菌以及腐生葡萄球菌对利福平、利奈唑胺以及万古霉素的敏感度达100.00％。感染组和未感染组在性别、住院时间、玻璃体溢出方面比较差异均无统计学意义（P>0.05）；两组在麻醉药时间、年龄、手术切口、手术时间、高血压、糖尿病方面比较差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：年龄≥66岁、手术切口为透明角膜、手术时间≥15 min、合并糖尿病均是发生感染性眼内炎的危险因素（OR=2.759、2.676、1.601、1.261，P<0.05）。结论：白内障术后感染性眼内炎的致病菌较多，以革兰阳性菌为主，革兰阳性菌对利福平、利奈唑胺、万古霉素的敏感度较高，年龄≥66岁、手术切口为透明角膜、手术时间≥15 min、合并糖尿病均会增加术后感染性眼内炎发生的风险。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the pathogenic bacteria of infective endophthalmitis after cataract surgery, and analyze the influencing factors. Methods: 2936 patients who underwent cataract surgery in our hospital from August 2016 to March 2019 were selected, the incidence of infective endophthalmitis after cataract surgery were counted. The distribution and drug resistance of pathogens in patients with postoperative infectious endophthalmitis were analyzed. Single factors and Multivariate Logistic regression were used to analyze the influencing factors of infectious endophthalmitis. Results: In this study, 2936 questionnaires were sent out and 2931 were recovered, the recovery rate was 99.83% (2931/2936). 53 of them had infective endophthalmitis, the incidence was 1.81% (53/2931). According to whether they had infective endophthalmitis, they were divided into infection group (n=53) and non infection group (n=2878). 41 strains of pathogenic bacteria were detected in infective endophthalmitis, of which 37 were Gram-positive bacteria, accounting for 90.24%. 4 strains of fungi were detected, which were Candida albicans, accounting for 9.76%. Among the 37 Gram-positive bacteria, Staphylococcus capitis, Staphylococcus epidermidis and Staphylococcus saprophytius were 100.00% sensitive to vancomycin, rifampicin and linezolid. There was no significant difference between the infected group and the uninfected group in gender, hospital stay and vitreous overflow (P>0.05). There were significant differences between the two groups in anesthesia time, age, operation incision, operation time, hypertension and diabetes (P<0.05). Multivariate Logistic regression analysis showed that: age greater or equal to 66 years old, operation incision of sclera tunnel, operation time greater or equal to 15 minutes, diabetes mellitus were all risk factors of infectious endophthalmitis (OR=2.759, 2.676, 1.601, 1.261; P<0.05). Conclusion: There are many pathogenic bacteria of endophthalmitis after cataract surgery, mainly Gram-positive bacteria. The sensitivity of Gram-positive bacteria to vancomycin, rifampicin and linezolid are high, age greater or equal to 66 years old, the operation incision of surgery is sclera tunnel, the operation time greater or equal to 15 minutes, and diabetes mellitus will increase the risk of postoperative infectious endophthalmitis. |
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