메티실린 감수성 표피포도알균(MSSE) 각막염과 메티실린 내성 표피포도알균(MRSE) 각막염의 비교 연구
Comparison of Methicillin-Sensitive Staphylococcus Epidermidis (MSSE) Keratits and Methicillin-Resistant Staphylococcus Epidermidis (MRSE) Keratitis
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목적: 메티실린 감수성 표피포도알균(MSSE)과 메티실린 내성 표피포도알균(MRSE) 각막염 군 간의 임상양상과 치료결과를 알아보고자하였다. 대상과 방법: 1997년 1월부터 2008년 12월까지 표피포도알균 각막염 환자를 대상으로 의무기록을 후향적으로 분석하였다. 메티실린감수성 결과에 따라 환자를 MSSE와 MRSE의 두 군으로 나누어 비교하였다. 결과: 두 군 간에 임상양상의 유의한 차이는 없었다. 항생제 감수성 검사상 두 군 모두 반코마이신, 목시플록사신, 레보플록사신에100% 감수성을 보였으나 세팔로틴, 노르플록사신, 시프로플록사신, 에리트로마이신에 MSSE군은 모두 100%, MRSE군은 각각 17%,50%, 52%, 57%의 감수성을 보여 유의한 차이를 나타냈다(p＜0.05). 최종시력은 두 군 간에 유의한 차이는 없었다. 결론: MSSE와 MRSE 두 군 모두 반코마이신과 최근의 3, 4세대 퀴놀론 항생제에 100% 감수성이 있었으나 MRSE군은 노르플록사신,시프로플록사신에 감수성이 약 50%로 현저히 떨어졌다. MSSE와 MRSE 두 군 모두에서 임상양상의 차이는 없었으며 비교적 좋은시력 예후를 보였다.
Abstract
Purpose: To investigate the clinical features and treatment outcomes between methicillin-sensitive Staphylococcus epidermidis (MSSE) and methicillin-resistant Staphylococcus epidermidis (MRSE) keratitis groups. Methods: A retrospective analysis of case series was conducted of all patients with keratitis caused only by Staphylococcus epidermidis from January 1997 through December 2008. Sex, age, history of trauma, systemic disease, previous ocular history, antibiotic sensitivity test results, and treatment outcomes were evaluated. Patients were categorized into two groups as MSSE and MRSE according to methicillin-sensitivity result, and a comparative analysis was performed. Results: There were no significant differences in clinical features, such as risk factors or size or location of keratitis between the two groups. All MSSE and MRSE isolates were sensitive to vancomycin, moxifloxacin, and levofloxacin. All MSSE and 17%, 50%, 52%, and 57% of MRSE isolates were sensitive to cephalothin, norfloxacin, ciprofloxacin, and erythromycin,respectively (p < 0.05). There was no significant difference in visual acuity between the two groups. Conclusions: All MSSE and MRSE isolates were sensitive to vancomycin and to third- or fourth-generation fluoroquinolones In addition, approximately 50% of MRSE isolates were sensitive to norfloxacin and ciprofloxacin. There were no significant differences in clinical features of keratitis caused by MSSE versus those of MRSE isolates. Both keratitis groups had relatively good visual prognoses.
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