세균각막염의 예후인자 및 항생제 감수성 변화에 대한 8년간의 고찰

• 영문명: Prognostic Factor and Antibiotic Susceptibility in Bacterial Keratitis: Results of an Eight-Year Period
• 발행기관: 대한안과학회
• 저자명: 김우진 권의용 이동욱 안민 유인천,Woo-Jin Kim, MD, Eui-Yong Kweon, MD, Dong-Wook Lee, MD, Min Ahn, MD, In-Cheon You, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume50,number10, 1495~1504쪽, 전체 10쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2009.10.15

영문 초록

Purpose: To identify the clinical manifestations and risk factors for poor visual outcome, as well as antibiotic susceptibility of isolates in bacterial keratitis. Methods: A total of 128 eyes in 128 patients with bacterial keratitis, who were diagnosed by smears and cultures from January 2000 to December 2007 were reviewed retrospectively. Sex, age, previous ocular disease, trauma history, pre-treatment duration, previous ocular surgery, clinical manifestation, causative bacteria, pre- and post-treatment visual acuity, and treatment results were evaluated. An initial univariate and multivariate logistic regression analysis was performed to identify and select the main prognostic factors. The antibiotic susceptibility was evaluated in 2 consecutive 4-year periods. Results: The mean age of the 128 patients was 59.0±18.2 years; 67 (52.3%) patients were male. The most common risk factor was ocular trauma (40.6%). The most prevalent isolate was coagulase-negative Staphylococcus (43.7%). Large size (p <0.001) and previous ocular disease (p <0.001) were significant prognostic factors in the multivariate logistic regression model. Resistance of cefazolin and aminoglycoside antibiotics that were commonly used as a combination therapy increased over the 8 years, but there was no significant difference in the 2 time periods tested (all p >0.05). Among the fluoroquinolone antibiotics, susceptibility of ciprofloxacin was 75.7%. Conclusions: In patients with bacterial keratitis, a large ulcer size and the presence of previous ocular disease were risk factors for poor visual outcome. Gentamicin, cefazolin, and ciprofloxacin should be avoided as primary monotherapy for bacterial keratitis.

키워드

Antibiotic susceptibility, Bacterial keratitis, Poor visual outcome, Risk factor