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題名 | Stenotrophomonas Maltophilia Keratitis and Scleritis=Stenotrophomonas Maltophilia引發角膜炎及鞏膜炎之報告 |
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作者 | 陳永豐; 鐘珮禎; 蕭靜熹; | 書刊名 | 長庚醫學 |
卷期 | 28:3 2005.03[民94.03] |
頁次 | 頁142-150 |
分類號 | 416.74 |
關鍵詞 | 角膜炎; 鞏膜炎; 嗜麥芽糖狹隘營養單胞菌; Stenotrophomonas maltophilia; Keratitis; Scleritis; |
語文 | 英文(English) |
中文摘要 | Backgorund: Stenotrophomonas maltophilia is a seldom-reported pathogen in ocular infections. The report describes six cases of Stenotrophomonas maltophilia (S. maltophilia) keratitis and scleritis. To our knowledge, this is the foremost report of S. maltophilia scleritis. Methods: Laboratory reports of patients diagnosed with S. maltophilia ocular infections were collected from the ophthalmic department of Chang-Gung memorial hospital from January 1, 2000, through December 31, 2003. On evaluation of risk factors, isolates, antibiotic sensitivities, and response to the treatment ensued. Results: Of the 6 reported cases, 5 related bacterial keratitis and 2 scleritis. (One case reported S. maltophilia keratitis and secondary scleritis.) The primary risk factor in such cases is ocular surgery. The organism cultured was the single isolate in three cases (50%). The susceptibility test showed that 50%, 83%, and 100% of the isolates were sensitive to ceftazidime, a combination of trimethoprim and sulfamethoxazole, and ciprofloxacin respectively. Discussion: Ocular surface compromise such as penetrating keratoplasty was a primary risk factor of S. maltophilia keratitis in our study. The results of isolates and the antibiotic sensitivities were different from previously published results. Our cases responded well to antibiotic therapy and antibiotic therapy combined with conjunctival autografting. One case of S. maltophilia keratitis and secondary scleritis had a poor prognosis, arguably associated with a co-infection of Mycobacteria chelonae. |
英文摘要 | 前言:Stenotrophomonas maltophilia是一種相當罕見於眼睛的細菌。我們研究並收集了六個由Stenotrophomonas maltophilia所引發的角膜炎及鞏膜炎病例。其中的Stenotrophomonas maltophilia鞏膜炎,就我們所知,是截至目前為止第一個病例報告。 方法:我們收集了自民國89年初至92年底,由林口長庚醫院眼科醫師診斷為Stenotrophomonas maltophilia引發眼睛感染的病例。我們主要探討的目標是造成感染的危險因子,培養出的菌種,對抗生素的敏感性測試,及病人對藥物與手術治療的反應。 結果:這六個病例中有五個是角膜炎,兩個是鞏膜炎。(其中一個病例是角膜炎及次發性鞏膜感染。)主要危險因子是眼部手術。培養出的菌種有一半的病例為單一菌種。對ceftazidime,trimethoprim-sulfamethoxazole,和ciprofloxacin的敏感性測試分別是50%,83%,及100%。 討論:在我們的研究中,眼部表層的不健全,譬如接受過全角膜移植手術,是一個很重要的危險因子。這一點和之前的研究報告相去不遠,但就培養出的菌種及對抗生素的敏感性測試結果而言,就有很大的差別。我們培養出的菌種多數為單一菌種,對抗生素的抗藥性也明顯比之前的報告低了許多。六個病例中,抗生素治療或加上自體結膜移植手術對其中五例有很好的成效。至於預後較差的那一病例,推測其可能原因是合併了Mycobacteria chelonae的感染。 |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。