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@#AIM:To investigate the age-related cataract patients' eyelid margin and conjunctival sac bacterial distribution and eliminating effects of different antibiotic eye drops and conjunctival sac washing fluid. <p>METHODS: A total of 216 age-related cataract patients(216 eyes)who were hospitalized for operation in our hospital were enrolled from January 2015 to November 2015, and randomly divided into three groups(72 eyes respectively): Patients in group A were treated with 3g/L tobramycin eye drop; group B were treated with 5g/L levofloxacin eye drop and group C were treated with both two eye drops before surgery. And then each group was randomly divided into two groups: moxifloxacin group(110 eyes)and povidone iodine group(106 eyes). After the routine disinfection and before the formal start of the operation, the conjunctival sac was irrigated with 1.6g/L moxifloxacin or 5g/L povidone iodine respectively. The conjunctival sac and lid margin specimen were collected before admission without any treatment, before and after conjunctival sac irrigation for germicultures and drug susceptibility tests, at the end of operation, conjunctival sac specimen and aqueous humor were collected for germicultures and drug susceptibility tests.<p>RESULTS:The germiculture positive rate of eyelid margin was 86.6% and the bacterial culture positive rate of conjunctival sac was 25.0% before operation. In groups A, B and C before and after topical antibiotics application, the germiculture positive rate of eyelid margin was 86.1% and 36.1%, 84.7% and 31.9%, 88.9% and 30.6% respectively; the germiculture positive rate of conjunctival sac was 25.0% and 11.1%,26.4% and 11.1%,23.6% and 8.3% respectively. In moxifloxacin group and povidone iodine group before and after conjunctival sac irrigation, the germiculture positive rate of eyelid margin was 33.6% and 10.9%, 32.1% and 10.4% respectively; the germiculture positive rate of conjunctival sac was 10.0% and 0, 10.4% and 0 respectively.<p>CONCLUSION: Both 5g/L levofloxacin eye drop and 3g/L tobramycin eye drop are effective in diminishing conjunctival sac or eyelid margin bacterium before cataract sugery, the combined effect is better. Both 5g/L PVP-I and 1.6g/L moxifloxacin can be used to irrigate conjunctival sac before cataract surgery.
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Objective To investigate the value of adenosine triphosphate(ATP)bioluminescence assay for assessing object surface contamination degree in intensive care unit(ICU).Methods 30 groups of high frequency contact object(including ventilator panel,bedside table and computer keyboard)in ICU from January to December 2016 were enrolled for the study. Each object was sampled and evaluated before and after disinfection,and their surface was divided into two areas,whose sur-face contamination degree was evaluated by ATP bioluminescence assay and bacterial culture method that were classified as ATP group and control group.The fluorescence detection value and colony number were compared between two groups be-fore and after disinfection.The correlation between the fluorescence detection value and colony number was analyzed by Pearson correlation in the same sample,and the Kappa consistency test was used for the qualification rates of two detections. Results ①The fluorescence detection value and colony number of ventilator panel,bedside table and computer keyboard af-ter disinfection in two groups were significantly lower than that before disinfection(t=8.107~26.393,all P<0.05).②Pearson analysis result showed that both before and after disinfection,the fluorescence detection value had no significant cor-relation with colony number of ventilator panel,bedside table and computer keyboard(r=0.199~0.338,all P>0.05).③There were no significant differences in the qualification rate between two groups of ventilator panel,bedside table and com-puter keyboard before and after disinfection(χ2=0.000~1.404,all P>0.05).The qualification rate before the disinfection of ATP group and control group were 0 and 8.9%,and that after disinfection were 86.7% and 91.1%,whose Kappa consis-tency test result showed that the Kappa value was 0.776(95%CI:0.575~0.978)>0.75,so the consistency was quite sat-isfied.Conclusion ATP bioluminescence assay could be used as a rapid and handy preliminary screening to assist bacterial culture method to evaluate the object surface contamination in ICU,and the result was satisfactory and it would be worthy of clinical application.
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Background Blepharitis is an induce factor for multiple ocular surface diseases.Research showed that bacteria play an important role in the pathogenesis of blepharitis.To make sure the pathogenic bacteria and effective antimicrobial agents are of clinical significance for the prevention and treatment of blepharitis.Objective The purpose of this study was 1o investigate the bacterial isolates of conjunctival sac secretion and meibomian secretion in the patients with blepharitis and study their in vitro antimicrobial susceptibility.Methods Forty-five patients with anterior blepharitis and 45 cases with posterior blepharitis were included in Beijing Chaoyang Hospital from December 2006 to December 2012,and 45 patients for laser in situ keratomileusis were enrolled in the same period as control group.The secretions of the conjunctival sac and meibomian were collected with sterile cotton swab,and bacterial isolates were cultured in bouillon culture-medium.The number of eyes with different bacteria was examined and calculated.Then the bacteria were switched to blood agar plates,and antimicrobial susceptibility test to erythromycin,gentamicin,tobramycin,rifampin,levofloxacin were performed by M ueller Hinton (M-H) medium paper method.Results The total germiculture positive rates were 81.1％,76.1％ and 65.0％ in the anterior blepharitis group,posterior blepharitis group and the control group,showing a significant difference among them (x2 =12.80,P=0.00).The germiculture positive rates in meibomian secretion were 84.4％ and 78.8％ in the anterior blepharitis group and the posterior blepharitis group,which were significantly higher than 67.8％ in the control group (x2=7.30,P =0.03).There was no statistically significant difference in the germiculture positive rate of conjunctival sac section among the three groups (77.8％,73.3％ and 62.2％) (x2 =5.60,P=0.06).The main bacteria in conjunctival sac secretion and meibomian secretion were staphylococcus epidermidis,staphylococcus aureus and corynebacterium in all the subjects,but streptococcus pneumoniae and gram-negative bacillus were not detected in the control group.Staphylococcus showed the highest susceptibility to gentamicin,tobramycin and rifampicin,with the sensitive rate ＞70％.Corynebacterium was susceptible to various drugs.Streptococcus pneumoniae had susceptibility to erythromycin and tobramycin.However,Gram-negative bacillus was not susceptible to all the drugs above.Conclusions Bacteria participate in the pathogenesis of blepharitis,but the germiculture positive rate,bacterial species and drug susceptibility of bacteria are obviously different between patients with blepharitis and normal population.Reasonable application of antimicrobial agents is important to blepharitis.
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Objective To investigate the sensitivity of the real-time fluorescence PCR technique and the bacterial culture for detecting the colonization of group B Streptococcus(GBS)in late pregnant women.Methods 2 specimens were collected from preg-nant women genital tract-rectal secretions swabs,one specimen for conducting the bacterial culture and another for conducting the real-time PCR technique to detect genital GBS.The accuracy and rapidness were compared between the two methods.308 cases of pregnant women were divided into the GBS positive group and the GBS negative group according to the detection results of the real time real-time fluorescence PCR technique.The relation between the occurrence of premature rupture of membranes with GBS was investigated by the comparative analysis.Results Among 308 pregnant women with GBS detection,18 cases were positive by the ordinary bacterial culture with the positive rate of 5.8%(18/308),while 28 cases were positive by the real-time fluorescent PCR with the positive rate of 9.4%(29/308).In the GBS positive group detected by PCR,the premature rupture of membranes occurred in 9 cases with the positive rate of 31%,while in the GBS negative group detected by PCR,which occurred in 33 cases with the pos-itive rate of 11.83%.Conclusion This survey shows that the positive detection rate of the real-time fluorescent PCR technique is significantly higher than that of the bacterial culture method,the application of this detection technique for detecting GBS provides the basis for rapidly diagnosing GBS and conducting the prophylactic use of antibacterial drugs more accurately and more effectively.
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Objective This research attempted at prevention of steam contamination and protection of medical staff in periodontal scaling. Methods Thirty sample patients without oral cavity or upper res-piratory tract infection, chronic disease, infectious disease or other contraindication were randomly classified into the experimental group and the control group.The former gargled with chlorhexidine in the process of periodontal scaling while the latter rinsing only. Oral cavity bacteria of both groups were sampled before and after operation;air samples were got at five periods of time(before operation, 10 minutes in operation, 20 minutes in operation, 30 minutes in operation, and end of operation) and germicnltured.The entire data were analyzed.Results Air samphng in periodental scaling and oral sample germiculture after the scaling in the experimental group were lower than those of the control group, P<0.01. Conclusions With effective disinfection and sta-ble characteristics, chlorbexidine can be popularly utilized in skin mucous membrane disinfection. Gargling with chlorhexidine in periodontal scaling eliminates bacteria and microorganism in oral cavity and resulting steam,thus reducing environmental pollution and protecting the health of medical staff.
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Objective To investigate the pathogen and drug susceptibility in appendical intracavity with appendicitis, and guide clinically the selection of reasonable antibiotics. Methods Germicultures and drug susceptibility tests were conducted for the secretions from appendical intracavity of the 71 patients with appendicitis. Result (1) Totally 9 species (63 cases) of bacterium were isolated from clinical samples, positive rate of isolation was 88.7%. The first one was escherichia coli (49 cases). (2) The positive rates of germiculture were no differences in patients with different types of appendicitis. Age and BMI were associated with the results of germiculture. Gender, temperature, neutrophil, fecalith were not associated with the positive germiculture. (3) The curative effect of the third and the fourth generation cephalosporins and carbapenems were well. The curative effect of the first generation cephalosporins, quinolones and penicillins were not well. Conclusion (1)In all samples,escherichia coli are the dominant species of bacterium. The distribution of isolation is no difference in patients with different types of appendicitis. (2) The third generation cephalosporins are commonly used in clinical treatment with the obvious anti-bacteria effects, The fourth generation cephalosporins and carbapenems can act as the optimal drug for serious infection. Quinolones is not the optimal antibiotics. Penicillins antibiotic is not proposed to be used.
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OBJECTIVE To investigate the distribution of acute appendicitis pathogens and their drug resistance,and to guide clinically the selection of reasonable antibiotics.METHODS Germicultures and drug sensitivity tests were conducted for the pus specimens from the 116 patients with acute appendicitis by ATB Expression bacteria(identifier).RESULTS Pathogens in 75 cases of 116 were found,with a positive rate of 64.7%,totally 85 strains of bacteria were isolated from clinical samples.Gram-negative bacilli had 72 strains,accounted for 84.7% and Gram-positives had 13 strains,(accounted) for 15.3%.The first three were Escherichia coli(54.1%),Pseudomonas aeruginosa(4.7%),and Klebsiella pneumoniae(4.7%).Sensitivity tests showed that resistance rates of E.coli to cefapirin,imipenem,compound(piperacillin),cefoxitin,and amikacin were 0,2.2%,10.9%,17.4%, and(23.9%).CONCLUSIONS Dominant pathogens in patients with acute(appendicitis) are intestinal bacilli,with(predominance) of E.coli;more emphasis should be placed on pathogen detections and drug sensitivity tests so that effective antibiotics could be selected and resistant bacteria be reduced and nosocomial infections be prevented.