서부 경남 지역 감염안내염의 원인균과 임상양상
Bacterial Bacterial Culture and Clinical Characteristics of Infectious Endophthalmitis in Western Gyeongsangnam-do
대한안과학회지 2020년 61권 12호 p.1458 ~ 1466
김병선, 홍채민, 최영제, 최유진, 조용운, 유웅선, 김성재, 정인영,
소속 상세정보
김병선 ( Kim Byoung-Seon )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
홍채민 ( Hong Chae-Min )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
최영제 ( Choi Young-Je )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
최유진 ( Choi Yu-Jin )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
조용운 ( Cho Yong-Wun )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
유웅선 ( Yoo Woong-Sun )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
김성재 ( Kim Seong-Jae )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
정인영 ( Chung In-Young )
Gyeongsang National University College of Medicine Gyeongsang National University Hospital Department of Ophthalmology
Abstract
목적: 서부 경남 지역 3차 의료기관에서 진단한 감염안내염 환자들의 원인균, 임상양상 및 시력예후를 알아보고자 하였다.
대상과 방법: 2010년 1월부터 2019년 6월까지 경상대학교병원에서 감염안내염으로 진단된 93명(98안)을 대상으로 후향적으로 의무기록을 분석하였으며 모든 환자에서 전방과 유리체 검체의 배양검사를 시행하였고 배양된 균의 종류, 치료 방법, 시력예후 등을 분석하였다.
결과: 대상 환자 98안에서 균이 배양된 경우는 67안(68.4%)이었으며 가장 흔한 감염안내염의 원인은 백내장수술 후 발생한 안내염이었고. 가장 흔한 원인균은 그람양성균인 Staphylococcus epidermidis (16.3%)이었다. 최종 최대교정시력을 1.0 logMAR을 기준으로분석한 결과 초진 최대교정시력이 안전수지 이상인 경우, 유리체절제술을 시행한 경우가 통계적으로 의미있는 예후를 보였다(p<0.001, p=0.021).
결론: 감염안내염 중 외인안내염은 백내장수술 후 많은 발생 빈도를 보이며 그람양성균인 Staphylococcus epidermidis가 가장 흔하며 좋은 시력예후를 보여주었다. 내인안내염은 간농양이 가장 흔한 감염병소이고 그람음성균인 Klebsiella pneumoniae가 흔하고 나쁜 시력예후를 보여주었다.
Purpose: To investigate the bacterial culture, clinical characteristics, and prognosis associated with infectious endophthalmitis in western Gyeongsangnam-do.
Methods: This study was a retrospective review of the medical records of 98 eyes that presented with infectious endophthalmitis from 2010 to 2019. All patients were analyzed for the type of causative bacteria, treatment method, and the visual prognosis.
Results: The bacterial cultures (n = 98 eyes) revealed bacterial growth in 67 eyes (68.4%). The most commonly isolated causative microorganism was Gram-positive Staphylococcus epidermidis (14.3%). As a result of analyzing the best corrected visual acuity (VA) based on 1.0 (logMAR), baseline VA was worse than counting fingers, and whether pars plana vitrectomy was undertaken showed a difference in the final visual acuity (p < 0.001, p = 0.021).
Conclusions: Exogenous endophthalmitis occurs frequently after cataract surgery, and S. epidermidis is the most
common causative agent, but a good visual prognosis resulted. Liver abscess was a common extraocular source of endogenous endophthalmitis and Klebsiella pneumonia was the most common causative agent for a poor visual prognosis.
키워드
Culture; Infectious endophthalmitis; Vitrectomy
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