75岁以下和75岁以上白内障手术患者结膜中头孢呋辛耐药细菌定植的风险

Archivos de la Sociedad Espanola de Oftalmologia Pub Date : 2025-10-01 DOI:10.1016/j.oftale.2025.08.006

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

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引用次数: 0

摘要

背景与目的：白内障术后眼内炎（PE）中分离的细菌减少为头孢呋辛耐药菌；年龄0 ~ 84岁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、糖尿病、肥胖和泪囊造口史（DCR-history）有关。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，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，采用多变量泊松回归，IBM SPSS Statistic for Windows，版本25.0。结果：糖尿病、肥胖、男性性行为和吸烟习惯在< 75岁的患者中更为普遍。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< 75岁时肠球菌、肠杆菌科和NFGNB的IRR高于≥75岁患者。

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Risk of conjunctival colonization by cefuroxime-resistant bacteria in cataract surgery patients younger than 75 years and aged 75 or older

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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Archivos de la Sociedad Espanola de Oftalmologia

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