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目的 探讨眼内炎患者房水玻璃体培养细菌菌属的分布特点及其变化规律。 方法 对 10年 (1989～ 1998)间培养的 5 2 2份眼内炎患者的房水玻璃体标本革兰氏染色 ,培养阳性细菌菌属分布及其变化规律进行回顾性分析。 结果 细菌培养标本 5 2 2份 (房水 2 6 1份 ,玻璃体 2 6 1份 ) ,培养阳性菌共 119株 (房水 4 4株 ,玻璃体 75株 ) ,平均培养阳性率为 2 2 .8% (房水阳性率为 16 .9% ,玻璃体阳性率为 2 8.7% )。培养阳性菌中 ,革兰氏阳性 (G+ )球菌 5 4株占 4 5 .4 % ,G+杆菌 2 4株 ,占 2 0 .2 % ,革兰氏阴性 (G- )杆菌 4 1株占 34.5 %。肠杆菌科比例最高占 18.5 % ,其次为微球菌占 16 % ,凝固酶阴性葡萄球菌占 12 .6 % ,假单胞属占 10 .9%。前后 5年的比较结果显示 ,G+ 球菌的百分比变化不大 ,G+ 杆菌下降了 13.9% ,G- 杆菌阳性增长了 11.7%。 结论 G+ 球菌与 G- 杆菌仍是导致细菌性眼内炎主要菌属 ,后者比例近 5年升高 ,这些变化应在临床诊治细菌性眼内炎时引起注意。
Objective To investigate the distribution characteristics and changes of bacteria genus in vitreous humor of aqueous humor in patients with endophthalmitis. Methods A retrospective analysis was performed on Gram stain, culture-positive bacterial genus and their changes in 522 cases of endophthalmitis patients cultured for 10 years (1989 ~ 1998). Results A total of 522 bacterial cultures were collected (266 in aqueous humor and 2661 in vitreous). A total of 119 positive bacteria were cultured (4 4 in aqueous humor and 75 in vitreous). The average positive rate of culture was 22.8 % (Positive rate of aqueous humor was 16.9%, vitreous positive rate was 8.7%). In the culture of positive bacteria, 54 strains of Gram-positive (G +) bacteria accounted for 45.4%, 24 strains of G + bacteria accounted for 20.2% and 41 strains of Gram-negative bacteria accounted for 34.5 %. Enterobacteriaceae accounted for the highest proportion of 18.5%, followed by Micrococcus 16%, coagulase-negative Staphylococcus accounted for 12.6%, Pseudomonas accounted for 10.9%. The comparison of the five years before and after showed that the percentage of G + cocci did not change much, the G + bacillus dropped by 13.9% and the G-bacilli increased by 11.7%. Conclusions G + cocci and G-bacilli are still the main bacteria causing bacterial endophthalmitis. The ratio of the latter increases over the past 5 years. These changes should be noticed in the clinical diagnosis and treatment of bacterial endophthalmitis.