比较碘化合物和左氧氟沙星作为术后灌药的效果;白内障手术后结膜细菌群和抗菌药敏感性。

IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Japanese Journal of Ophthalmology Pub Date : 2024-09-06 DOI:10.1007/s10384-024-01117-8
Kazuki Matsuura, Dai Miyazaki, Yoshitsugu Inoue, Yumi Sasaki, Yumiko Shimizu
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引用次数: 0

摘要

目的:比较术后滴用碘化合物(PAI)和左氧氟沙星后结膜囊的清洁度:前瞻性开放标签研究:对 128 名接受常规白内障手术的患者进行了为期一周的术后局部使用左氧氟沙星或四倍稀释的 PAI 的研究。在三个时间点采集结膜样本:手术前、术后 1 周和术后 1 个月:结果:术后碘伏和左氧氟沙星的细菌培养阳性率分别为:术前 88.1%和 85.2%,术后 1 周 71.6%和 50.8%,术后 1 个月 92.5%和 86.5%。两组的细菌培养阳性率在术后 1 周均显著下降,术后 1 个月则恢复到基线水平。聚合酶链反应检测到的DNA拷贝数在1周时的下降幅度在左氧氟沙星组中较大,但在手术前和术后1个月时未见明显差异。左氧氟沙星组在 1 周时只有一株菌株培养呈阳性,但其对表皮葡萄球菌的最低抑菌浓度(MIC)很高(128 µg/ml)。MIC 值从手术前的 2.31 ± 2.19 µg/ml 增加到术后 1 个月的 57.14 ± 22.34 µg/ml,而碘组没有发现明显变化:结论:术后碘酒和左氧氟沙星滴眼液都能减少结膜囊的细菌污染,其中左氧氟沙星组的消毒水平更高。不过,术后使用左氧氟沙星滴眼液会增加高耐药性细菌的出现,而碘酒组则没有出现这种情况。
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Comparison of iodine compounds and levofloxacin as postoperative instillation; conjunctival bacterial flora and antimicrobial susceptibility following cataract surgery.

Purpose: To compare the cleanliness of the conjunctival sac following the use of iodine compounds (PAI) and levofloxacin as postoperative eye drops.

Study design: A prospective open-label study.

Patients and methods: Either topical levofloxacin or fourfold-diluted PAI was administered for 1 week postoperatively in 128 eyes of 128 patients who underwent routine cataract surgery. Conjunctival samples were obtained at three time points: pre-surgery, 1 week postoperatively, and 1 month postoperatively.

Results: The respective positive bacterial culture rates for postoperative iodine and levofloxacin were 88.1% and 85.2% pre-surgery, 71.6% and 50.8% 1 week postoperatively, and 92.5% and 86.5% 1 month postoperatively. Positive bacterial culture rates in both groups significantly declined at 1 week, and the rates returned to the baseline level 1 month postoperatively. The magnitude of reduction of DNA copy number detected by polymerase chain reaction at 1 week was larger in the levofloxacin group, although no significant differences were seen at pre-surgery or 1 month postoperatively. In the levofloxacin group, only one strain was culture positive at 1 week, however, its minimum inhibitory concentration (MIC) against S. epidermidis was high (128 µg/ml). The MIC value increased from 2.31 ± 2.19 µg/ml pre-surgery to 57.14 ± 22.34 µg/ml 1 month postoperatively, while no significant change was found in the iodine group.

Conclusion: Postoperative iodine and levofloxacin eye drops both reduced bacterial contamination in the conjunctival sac, with a superior level of disinfection in the levofloxacin group. However, postoperative levofloxacin eye drops enhanced the emergence of highly resistant bacteria, whereas no such development was seen in the iodine group.

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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
65
审稿时长
6-12 weeks
期刊介绍: The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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