Riesgo de colonización conjuntival por bacterias cefuroxima-resistentes en la cirugía de cataratas de pacientes menores de 75 años y en los de esa edad o mayor

Q3 Medicine

Archivos De La Sociedad Espanola De Oftalmologia Pub Date : 2025-10-01 DOI:10.1016/j.oftal.2025.06.004

J.L. Urcelay-Segura , J.M. Bellón-Cano , T. Cuesta-Rodríguez , M.E. Fernández-Rubio

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引用次数: 0

Abstract

Background and objective

Bacteria isolated in postoperative endophthalmitis (PE) were reduced to cefuroxime-resistant bacteria in cataract surgery with intracameral cefuroxime as prophylaxis; age > 84 years was at risk for PEs caused by Gram-negative-bacteria and Staphylococci; no risks were identified for Enterococci, the most abundant isolations. The prevalence of Enterococci in the preoperative conjunctiva was associated with age > 74 years, diabetes, obesity, and dacryocystorhinostomy-history (DCR-history). The aim of the study is to differentiate the risk of age from that of other patient characteristics, establishing 2 different age groups.

Materials and methods

We conducted a retrospective cross-sectional study in a tertiary referral center. In 7,085 patients < 75 years old and 7,798 ≥ 75 years, the incidence rate ratio (IRR) of Enterococci, Enterobacteriaceae, Non-fermentative-Gram-negative-bacilli (NFGNB) and Coagulase-negative-Staphylococci (CNS) was calculated for the following factors: diabetes, obesity, DCR-history, sex-male, smoking-habit, and climate, using multivariate Poisson regression, IBM SPSS Statistic for Windows, version 25.0. Armonk, NY: IBM Corp.

Results

Diabetes, obesity, male-sex and smoking-habit were more prevalent in patients < 75 years old. The IRRs of Enterococci, Enterobacteriaceae and NFGNB were higher in this age group: [Enterococci IRRs: diabetes, 1.54 vs 1.42; obesity, 2.95 vs 1.50; DCR-history, 3.78 vs 1.08]; [Enterobacteriaceae IRRs: diabetes, 1.47 vs 1.13; obesity, 2.27 vs 1.99; male-sex, 1.76 vs 1.65]; [NFGNB IRRs: diabetes, 1.79 vs 1.16; autumn-weather, 2.05 vs 1.56]. Diabetes-obesity simultaneously: Enterobacteriaceae IRR, 3.30 vs 2.28; Enterococci IRR, 3.28 vs 1.62.

Conclusions

Diabetes, obesity and DCR-history increase the IRR of Enterococci, Enterobacteriaceae and NFGNB in patients < 75 years more than they actually do in patients ≥ 75.

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75岁以下和75岁以上患者在白内障手术中被耐头孢菌素细菌定植的风险

背景与目的应用头孢呋辛预防白内障术后眼内炎（PE）的细菌减少为头孢呋辛耐药菌；84岁的患者存在革兰氏阴性菌和葡萄球菌所致PEs的风险；未发现最丰富的分离株肠球菌的风险。术前结膜中肠球菌的流行与年龄（74岁）、糖尿病、肥胖和泪囊造口史（DCR-history）相关。该研究的目的是区分年龄与其他患者特征的风险，建立了两个不同的年龄组。材料和方法我们在一家三级转诊中心进行了回顾性横断面研究。在7085例75岁和7798例≥75岁的患者中，采用IBM SPSS统计软件（Windows） 25.0版本的多元泊松回归，计算肠球菌、肠杆菌科、非发酵革兰氏阴性杆菌（NFGNB）和凝固酶阴性葡萄球菌（CNS）的发病率比（IRR），考虑以下因素：糖尿病、肥胖、dcr病史、性别-男性、吸烟习惯和气候。结果糖尿病、肥胖、男性性行为和吸烟习惯在75岁以上的患者中更为普遍。该年龄组肠球菌、肠杆菌科和NFGNB的IRRs较高：[肠球菌：糖尿病，1.54 vs 1.42；肥胖，2.95比1.50；dcr -病史（3.78 vs 1.08）；[肠杆菌科IRRs：糖尿病，1.47 vs 1.13；肥胖，2.27 vs 1.99；男性（1.76 vs 1.65）；[NFGNB irs：糖尿病，1.79 vs 1.16；秋天的天气，2.05 vs 1.56]。糖尿病-肥胖同时发生：肠杆菌科IRR， 3.30 vs 2.28；肠球菌IRR为3.28 vs 1.62。结论糖尿病、肥胖和有dcr病史的患者中肠球菌、肠杆菌科和NFGNB的IRR比实际≥75岁的患者高75岁。

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来源期刊

Archivos De La Sociedad Espanola De Oftalmologia Medicine-Ophthalmology

CiteScore

1.20

自引率

0.00%

发文量

109

审稿时长

78 days

期刊介绍： La revista Archivos de la Sociedad Española de Oftalmología, editada mensualmente por la propia Sociedad, tiene como objetivo publicar trabajos de investigación básica y clínica como artículos originales; casos clínicos, innovaciones técnicas y correlaciones clinicopatológicas en forma de comunicaciones cortas; editoriales; revisiones; cartas al editor; comentarios de libros; información de eventos; noticias personales y anuncios comerciales, así como trabajos de temas históricos y motivos inconográficos relacionados con la Oftalmología. El título abreviado es Arch Soc Esp Oftalmol, y debe ser utilizado en bibliografías, notas a pie de página y referencias bibliográficas.