Citation:Gao W, Xia T, Chen HB, Pan XJ, Huang YS, Wang X, Dong YL, Xie LX. Ocular bacterial infections at a tertiary eye center in China: a 5-year review of pathogen distribution and antibiotic sensitivity. Int J Ophthalmol 2020;13(1):54-60,doi:10.18240/ijo.2020.01.08
Ocular bacterial infections at a tertiary eye center in China: a 5-year review of pathogen distribution and antibiotic sensitivity
Received:April 22, 2019  Revised:November 20, 2019
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DOI:10.18240/ijo.2020.01.08
Key Words:bacteria  ocular infections  pathogen  antibiotic sensitivity
Fund Project:Supported by the National Natural Science Foundation of China (No.81670839); the Shandong Medical and Health Science and Technology Development Program (No.2016WS0265); the Qingdao People’s Livelihood Science and Technology Project (No.16-6-2-14-nsh).
                       
AuthorInstitution
Wen Gao 1School of Medicine, Shandong University, Jinan , Shandong Province, China;Anhui No.2 Provincial People’s Hospital, Hefei , Anhui Province, China
Tian Xia State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
Hua-Bo Chen State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
Xiao-Jing Pan State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
Yu-Sen Huang State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
Xin Wang State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
Yan-Ling Dong State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
Li-Xin Xie State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao , Shandong Province, China
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Abstract:
      AIM: To provide statistical evidence for the use of antibiotics in ophthalmology by assessing the distribution and antibiotic sensitivity of bacterial isolates from ocular specimens with suspected microbial infections.

    METHODS: This study applied a retrospective analysis of 3690 bacterial isolates from ocular specimens, which were obtained from the conjunctiva, cornea, aqueous humor, vitreous body, and other ocular sites of the patients at Shandong Eye Institute in northern China from January 2013 to December 2017. The parameters assessed mainly included the distribution of isolated bacteria and the results of susceptibility tests for antibiotics. In the analysis of antibiotic sensitivities, the bacteria were divided into four groups according to gram staining, and statistical methods were used to compare their antibiotic sensitivities.

    RESULTS: Among the 3690 isolated bacterial strains, Staphylococcus epidermidis (2007, 54.39%) accounted for the highest proportion. As for the total isolates, their sensitivity rate to gatifloxacin was up to 90.01%, with four types of gram-stained bacteria being all highly sensitive to it, but their sensitivity rate to levofloxacin was only 51.91%. The sensitivity rate of gram-negative bacilli (G-B) to levofloxacin was 83.66%, significantly higher than the other three types of gram-stained bacteria (P<0.05). Gram-positive cocci (G+C, 97.95%) and gram-positive bacilli (G+B, 97.54%) were more sensitive to vancomycin than gram-negative cocci (G-C, 70.59%) and G-B (68.57%; P<0.05). For fusidic acid, the sensitivity rates of G+C (89.83%) and G+B (73.37%) were significantly higher than that of G-B (29.83%; P<0.05). The gram-negative bacteria’s sensitivity rate to cefuroxime was as low as 59.25%, but only G-B was less sensitive to cefuroxime (57.28%), while G-C was still highly sensitive (89.29%). The sensitivity rate of gram-positive bacteria to moxifloxacin was as high as 80.28%, but only G+C was highly sensitive to moxifloxacin (81.21%), while G+B was still less sensitive (32.00%).

    CONCLUSION: Staphylococcus epidermidis is the predominant isolate in all ocular specimens with bacteria. Gatifloxacin is more suitable for topical prophylactic use than levofloxacin in ophthalmology when necessary. Vancomycin and fusidic acid both have better effects on gram-positive bacteria than gram-negative bacteria. More accurate antibiotic sensitivity analysis results can be obtained when a more detailed bacterial classification and more appropriate statistical methods are performed.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942948/
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