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Thepathogensanditsresistancetoantibioticsinbacterialkeratitis:a42yearreviewLiangYanchuang,WangZhiqun,LiRan,LiangQingfeng,LuoShiyun,DengShijing,AnYing,SunXuguang.BeijingInstituteofOphthalmology,BeijingTongrenEyeCenter,CapitalUniversityofMedicalSciences,Beijing100005,ChinaAbstractObjectiveThebiologicalfeatures,bacterialspectrumandthesusceptibilityofpathogensvarywiththeutilizationofantibioticsinophthalmology.Itisnecessarytoanalyzethebacterialdistributionineyeandresistanceregularitytoantibiotics.Incurrentpaper,westudiedthedistributionofbacteriaisolatesfromthekeratitisinNorthChinaandtheirsusceptibilitytofluoroquinolones.Methods1985cornealspecimensfrompatientswithbacterialkeratitisfromJanuary2001toDecember2004werecultivated,andthepathogenesisspectrumandresistanceofculturedbacteriatoantibioticswereanalyzed.Results279of1985isolatesspecimen(from151maleand128female,meanage45114years)werebacterialpositiveinculture,showingapositiverateof14106%.ThepositivecultureoutcomeofGrampositivecocciandGramnegativebacilliwas42165%(119/279)and35113%(98/279)respectively.Pseudomonassp.wasthemostcommonpathogen(20107%).Resistanceoftheculturedbacteriawas2012%toofloxacin,3519%tociprofloxacin,1515%tolevofloxacinand2914%totobramycin.SignificantresistanceabilitywasrevealedinStaphycoccussp.tociproloxacinandstreptococcussp.totobramycin.TheGramnegativebacillishowedastrongerresistancetociproloxacinthantoofloxacinandlevofloxacin(2=71486,111932;P0101).Theresistanceofisolatesintheelderpeople(60years)tociprofloxacin,levofloxacinandtobramycinwasstrongerthanthatintheotherage(14to59y)(2=141744,51835,191709;P0105).ConclusionPseudomonassp.andStaphycoccussp.arethemostcommonpathogensofbacterialkeretitis.Theincreasedfluoroquinolonesresistanceofthesepathogenspresentsanimportanttherapeuticchallengeforbacterialkeretitis.Keywordskeretitis;bacterium;drugresistance;etiology1985,279,14106%;119(42165%)58(20179%)98(35113%)4(1143%),20107%2012%3519%1515%2914%(2=141744,51835,191709;P0105),;;;R772A100320808(2007)0420306204,,:100005,(,,,100025):(Email:sunxuguang@yahoo.com),200120041985,603ChinOphthalRes,April2007,Vol.25,No.411.120011200412,1.2,,,35372472h,,()K2B,MH(5%10%),(),353724h,,NCCLS,(1)1Table1ThestandardofmicrobialsensitivitytestsAgentsContents(g/slip)Diameterofbacteriostasis(mm)ResistanceIntermediateSensitivityOfloxacin51213-1516Ciprofloxacin51516-2021Levofloxacin101314-1617Tobramycin101213-14151.3SPSS11152,P010522.1200120041985,279,14106%2001200415100%15102%12136%13188%2.222.3279,151,128,11181;10d96,45114;(014)14,(1559)193,(60)722(n,%)Table2Isolatesdistributionofpositiveculture(n,%)BacteriaPositiveisolatesindifferentyearTotal2001-20022003-2004Staphylococcusepi.22/15.8317/12.1439/13.98Staphylococcusaur.9/6.4711/7.8620/7.17Micrococcussp.18/12.959/6.4327/9.68Streptococcuspne.11/7.9110/7.1421/7.53Streptococcus2hem.3/2.163/2.146/2.15otherG+cocci2/1.444/2.866/2.15G+cocci65/46.7654/38.57119/42.65Corynebacteriumsp.22/15.8325/17.8647/16.85Actinomycessp.3/2.163/2.146/2.15Bacillussp.3/2.161/0.714/1.43otherG+bacilli1/0.710/01/0.3G+bacilli29/20.8629/20.7158/20.79Pseudomonassp.25/17.9931/22.1556/20.07Cedeceasp.7/5.040/07/2.51Serratiasp.1/0.713/2.144/1.43Proteussp.0/02/1.432/0.72Klebsiellasp.2/1.442/1.434/1.43OtherG-bacilli8/5.7617/12.1425/8.96G-bacilli43/30.9455/39.2998/35.12G-cocci2/1.442/1.434/1.43Total139/100140/100279/100;,(2=151644,P0101)33Table3Isolatesdistributionofthebacterialkeratitisinage2groups(n,%)BacteriaPositiveisolatesindifferentage0-14(y)15-59(y)60(y)Staphylococcussp.467/34.719/26.4bStreptococcussp.211/5.716/22.2TotalG+cocci678/40.435/48.6Corynebacteriumsp.233/17.112/16.7OtherG+bacilli010/5.21/1.4TotalG+bacilli243/22.313/18.1Pseudomonassp.442/21.810/13.9OtherG-bacilli227/14.013/18.0TotalG-bacilli669/35.823/31.9TotalG-cocci03/1.51/1.4Total14193/10072/100bP0105vsrespective15-59yearsgroup(2test)2.42452018%3519%1515%2914%(4),(2=261709,131551;P0101);,(2=70320074254131749,41787;P0105);,(P0105)4Table4Sensitivitytestsofthecornealisolates(n,%)BacteriaOfloxacinCiprofloxacinLevofloxacinTobramycinSI+R%SI+R%SI+R%SI+R%G+cocciStaphylococcusepi.241538.5182153.8251435.9231641.0Staphylococcusaur.16420.011945.017315.013735.0Micrococcussp.21622.2171037.02527.423414.8Streptococcuspne.17315.013735.016420.041680.0Streptococcus2hem.3240.03240.03240.01480.0Streptococcus2hem.02100.01150.0200200OtherG+cocci2250.02250.02250.03125.0G+bacilliCorynebacteriumsp.23723.3181240.025516.723723.3Actinomycessp.200200200200OtherG+bacilli500500500500G-bacilliPseudomonassp.49610.9421323.65323.648712.7Klebsiellasp.4003125.04003125.0Serratiasp.4003125.04003125.0Proteussp.3002133.33002133.3OtherG-bacilli19313.615731.818418.215731.8G-coccus2133.32133.3300300Total1945120.8b1578835.92073815.5c1737229.4bP0105vsrespectiveciprofloxacinandtobramycin;cP0101vsrespectiveciprofloxacinandtobramycin(2test)3resistancepercentageofantibiotics(%)=n(I+R)/n(S+I+R)100%2.54(5)4617%,,(2=51288,131118,41582;P0105)7411%,,(2=121519,71500,141538;P0101)54(%)Table5Antibioticresistancepercentageofcornealisolates(%)Bacte