세균성 안내염의 임상결과: 원인균 동정과 시력 예후
Clinical Results of Bacterial Endophthalmitis: Bacterial Culture and Visual Acuity Outcomes
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목적: 세균성 안내염 환자의 원인 미생물의 종류와 배양 양성률 및 시력 예후에 대해 알아보고자 하였다. 대상과 방법: 2000년 1월부터 2009년 6월까지 본원에서 치료받은 세균성 안내염 환자 59명을 대상으로 의무기록을 후향적으로 조사하였고, 모든 환자에서 전방과 유리체 검체의 배양검사를 하여 배양 양성률, 배양균 종류 및 시력 예후에 대하여 분석하였다. 결과: 전체 59안 중 균이 배양된 경우는 37안(63%)이었다. 유리체 검체를 배양한 35안과 전방수 검체를 배양한 27안 중 각각 22안(63%)과 12안(44%)에서 균이 배양되었다. 이 중 응고효소음성 Staphylococcus종이 30% (11안), 그 밖의 그람 양성균이 43% (16안),그람 음성균이 24% (9안)이었고 1안에서 혼합감염균이 배양되었다. 최종시력이 0.5 이상인 경우는 전체 59안 중 16안(27%)이었으며응고효소음성 Staphylococcus종이 45% (5안/11안)로 가장 많았다. 결론: 전체 배양 양성률은 63%였고 유리체 검체에서 전방수 검체에서 보다 높게 배양되었다. 가장 흔한 원인균은 응고효소음성Staphylococcus종이었으며, 이 경우 시력예후가 가장 좋았다.
Abstract
Purpose: To evaluate the clinical characteristics of bacterial culture, and visual outcome in patients with acute endophthalmitis. Methods: Clinical records of patients treated for acute endophthalmitis in GNUH from 2000 to 2009 were reviewed. The specimens for culture were obtained from the anterior chamber or vitreous. Clinical outcome measures were bacterial culture,culture rate, and final visual acuity. Results: Cultures (total 59 cases) showed bacterial growth in 37 cases (63%). Among 35 cases vitreous specimens, bacteria growth was found in 22 cases (63%), and from the 27 anterior chamber specimens, 12 cases (44%) were culture positive. From these 37 bacterial-positive cultures, 11 (30%) were coagulase negative Staphylococcus species, 16(43.0%) were other Gram-positive species, 9 (24%) were Gram-negative species, and 1 (3%) produced a polymicrobial culture. Final visual acuity above 0.5 was achieved in 16 of 59 (27%) cases and coagulase negative Staphylococcus species had the greatest proportion being 5 of 11 (45%). Conclusions: The bacterial culture positivity rate in bacterial endophthalmitis was 63%, and the culture yield rate from the vitreous was higher than the anterior chamber aqueous samples. Coagulase negative Staphylococcus species were the most common causative organisms and showed the best final visual outcome in endophthalmitis.
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