감염성 안질환의 원인균 및 항생제 감수성에 대한 10년간의 고찰
Cultured Organisms and Antibiotic Susceptibility in Infectious Ocular Disease: Results Over a Ten-Year Period
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목적: 원인균이 동정된 감염성 안질환 환자를 대상으로 부위별 발생빈도 및 원인균주, 항생제 감수성결과를 알아보았다. 대상과 방법: 2000년 1월부터 2009년 12월까지 10년간 본원에서 감염성 안질환이 의심되는 환자 중 균 도말, 배양검사를 실시하여원인균이 동정되었던 519명, 519안을 대상으로 의무기록을 후향적으로 조사하였다. 결과: 대상 환자 519명의 평균연령은 54.0세였고, 남자가 66.1%이었다. 전신질환은 당뇨병, 과거 안질환은 각결막염을 앓았던 경우가많았다. 검체는 각막에서 가장 많이 채취되었고, 전체 원인균 중 세균은 81.2%, 진균은 18.8%이었으며 표피포도알균이 가장 흔한 원인균이었다. 진균은 푸사륨이 가장 빈번하였다. 반코마이신, 세프타지딤, 4세대 퀴놀론제제는 높은 항생제 감수성을 유지하였다. 메티실린 내성 표피포도알균이나 황색포도알균이 조사기간 후반기로 갈수록 증가하는 경향을 보였고 안내염에서 출현이 더 많았다. 결론: 감염성 안질환은 호발균, 임상양성 및 항생제 감수성 검사의 분석을 통해 효과적인 치료를 할 수 있으리라 생각한다. 최근 메티실린 내성 포도구균이 증가하는 경향이므로 주의해야 한다.
Abstract
Purpose: To investigate the ocular regional incidence, causative species and antibiotic susceptibility in patients with infectious ocular disease whose causative organism was isolated. Methods: A total of 519 eyes in 519 patients with infectious ocular disease, who were diagnosed by smears and cultures from January 2000 to December 2009 were retrospectively reviewed. Results: The mean age of the 519 patients was 54.0 years, and 66.1% of the patients were male. The most common systemic disease was diabetes mellitus. The most common previous ocular disease was keratoconjunctivitis. Specimens were most frequently swabbed from the cornea, where 81.2% were bacteria isolates and 18.8% fungi isolates. The most prevalent causative organism was Staphylococcus epidermidis, and the most prevalent fungus was Fusarium species. Vancomycin, ceftazidime, and fourth-generation fluoroquinolone maintained high antibiotic susceptibility. Methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis were increasing near the end of the reference period, and endophthalmitis was more common in methicillin-resistant Staphylococcus. Conclusions: Identifying the causative organism in infectious ocular disease by smears and cultures is essential. More effective treatment of infectious ocular disease would be possible by analyzing the frequent organism, clinical manifestations,and antibiotic susceptibility. More caution is necessary due to the increase in methicillin-resistant Staphylococcus.
참고문헌 (17)
- Khosravi AD, "Bacteriological findings in patients with ocular infection and antibiotic susceptibility pattern of isolated pathogens", Singapore Med J, 48, pp.741~743 (2007)
- McClellan KA., "Mucosal defense of the outer eye", Surv Ophthalmol, 42, pp.233~246 (1997)
- Jones DB., "Decision-making in the management of microbial keratitis", Ophthalmology, 88, pp.814~820 (1981)
- Blanton CL, "Initial treatment of microbial keratitis", CLAO J, 22, pp.136~140 (1996)
- Limberg MB., "A review of bacterial keratitis and bacterial conjunctivitis", Am J Ophthalmol, 112(4 Suppl), pp.2~9 (1991)
- Liesegang TJ., "Bacterial keratitis", Infect Dis Clin North Am, 6, pp.815~829 (1992)
- Afshari NA, "Trends in resistance to ciprofloxacin, cefazolin, and gentamicin in the treatment of bacterial keratitis", J Ocul Pharmacol Ther, 24, pp.217~223 (2008)
- Synder ME, "Ciprofloxacin resistant bacterial keratitis", Am J Ophthalmol, 114, pp.336~338 (1992)
- Williamson-Noble FA, "Etiology of the eye diseases; developmental defects; heriedity, In The Eye and Its Diseases, 2nd ed", pp.309~321 (1950), WB Saundars Company
- Hahn YH, "Antibiotic susceptibilities of ocular isolates from patients with bacterial keratitis: a multi-center study", J Korean Ophthalmol Soc, 40, pp.2401~2410 (1999)
- Jensen HG, "In vitro antibiotic susceptibilities of ocular isolates in North and South America. In Vitro Antibiotic Testing Group", Cornea, 17, pp.79~87 (1998)
- Ooishi M, "Antibiotic sensitivity of recent clinical isolates from patients with ocular infections", Ophthalmologica, 211(Suppl), pp.15~24 (1997)
- Ramesh S, "Prevalence of bacterial pathogens causing ocular infections in South India", Indian J Pathol Microbiol, 53, pp.281~286 (2010)
- Kim HT, "The cultured organisms and in vitro antibiotic sensitivity of ocular bacterial infection", J Korean Ophthalmol Soc, 40, pp.971~979 (1999)
- Kalkanci A, "Ocular fungal infections", Curr Eye Res, 36, pp.179~189 (2011)
- Thomas PA., "Fungal infections of the cornea", Eye, 17, pp.852~862 (2003)
- Freidlin J, "Spectrum of eye disease caused by methicillin-resistant Staphylococcus aureus", Am J Ophthalmol, 144, pp.313~315 (2007)