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目的查明一起白内障术后引起眼内感染的病原菌及其来源。方法采用现场流行病学方法,对所有可能引起眼内感染的医疗器械、环境物表、洗手用水以及药物等进行分离培养和细菌学鉴定,同时使用脉冲场凝胶电泳(PFGE)技术对患者和环境分离的菌株进行同源性鉴定。结果 3例患者眼拭子或眼前房水中均检出铜绿假单胞菌,有4处手术室洗手用水检出铜绿假单胞菌。经过PFGE鉴定,3例患者眼睛中的铜绿假单胞菌和3处洗手用水中的铜绿假单胞菌具有同源性。患者感染的铜绿假单胞菌来源于洗手用水。尽管术后及时在眼内使用抗生素,但是效果并不好,其中1例患者眼球被摘除。结论 PFGE鉴定结果显示,这是一起由铜绿假单胞菌引起的白内障术后感染事件。
Objective To identify a pathogen that causes intraocular infection after cataract surgery and its source. Methods The on-site epidemiological methods were used to isolate and identify all the medical devices, environmental objects, hand-washing water and drugs which may cause intraocular infection. Meanwhile, the use of pulsed-field gel electrophoresis (PFGE) Homology identification of strains isolated from the environment. Results Pseudomonas aeruginosa was detected in 3 eyes of patients with eye swab or anterior chamber eye water, and Pseudomonas aeruginosa was detected in 4 operating rooms. After PFGE identification, Pseudomonas aeruginosa in the eyes of 3 patients had homology with Pseudomonas aeruginosa in 3 hands-washing water. Patient infected Pseudomonas aeruginosa comes from hand-washing water. Although antibiotics are used intraocularly promptly after surgery, the effect is not good, and one patient’s eyeball is removed. Conclusion The PFGE results show that this is a post-cataract infection caused by Pseudomonas aeruginosa.