| Objective：Meibomian gland dysfunction (MGD) is a chronic, diffuseabnormality of the meibomian glands, commonly characterized by terminalduct obstruction and/or qualitative/quantitative changes in the glandularsecretion. Patients with MGD usually complain with ocular discomfort, suchas foreign body sensation, dryness and so on. Easily ignored by clinicians,therefore, patients have to choose more hospitals. The patients are worriedabout no recovery, for being treated a long time. At the begining of theintraocular surgery, the extrusion and stimulation of eyelid retractor to theeyelid forces the secretions from the meibomian gland to the conjunctival sac.Then the risk of intraocular infection increases. Therefore, we want to foundout the bacteria distribution and the drug sensitivity status of meibomian glandsecretions and the conjunctival sac by bacterial culture. Then we can providebasis for the treament of MGD and reduce the rate of intraocular surgeryinfections. Meanwhile, we choose two solutions to wash the conjunctival sac.By comparing the effect of them to reduce the occurrence of endophthalmitis.Methods：66cases of66eyes with obvious symptomatic MGD wererandomly divided into two groups: the control group of30cases (30eyes) andthe trial group of36cases (36eyes). Patients were asked about their historiesin detail, and then they were given the ocular routine examinations. The twogroups of patients are given the tests of tear film breakup time, fluorescein andthe Schirmer test. Then the two groups were treated respectively. The controlgroup: Bacterial culture and drug sensitive test of conjunctival sac, meibomiangland secretions and the conjunctival sac after washed by the sterilephysiological saline were made. The trial group: Bacterial culture and drugsensitive test of conjunctival sac, meibomian gland secretions and theconjunctival sac after washed by anerdian III skin and mucosa disinfectant were made. Then the patients were treated according to the local symptom.After a week, their drugs might be adjusted according to the result of bacterialculture and drug sensitive test.Results：The results of bacterial culture: Of the198samples, bacteriawere detected in41samples, and the positive rate was20.7%. Meanwhile,every sample with only one species, which was Staphylococcus epidermidis ofCoagulase-negative Staphylococcus (CNS). The bacterial culture positive rateof conjunctival sac was15.2%, which were8.3%and23.3%in the trial groupand control group respectively. The bacterial culture positive rate ofmeibomian gland secretions was36.4%, which were38.9%and33.3%in thetrial group and control group respectively. The bacterial culture positive rateof conjunctival sac after washing in trial group and control group were2.8%and20.0%respectively. In the trial group, the comparison before and afterwashing indicated that the bacteria strains decreased obviously after washedby anerdian disinfectant (P<0.05). In the control group, there was notstatistical significance in the comparison before and after washed by thephysiological saline (P>0.05). When compared the trial group with thecontrol group, the washing effect of anerdian disinfectant is better than thephysiological saline (P<0.05). There was statistical significance between thebacterial culture positive rate of meibomian gland secretions and sexdifferences (P<0.05). There was not statistical significance between thebacterial culture positive rate of conjunctival sac and sex differences (P>0.05).There was not statistical significance between the bacterial culture positiverate of the above two places and age, alternative eye, residence, workenviroment, history and the lid margin differences (P>0.05).The result of drug sensitive test: Staphylococcus epidermidis was100%susceptible to Vancomycin, Teicoplanin, Minocycline and Linezolid, whichwas97.6%susceptible and2.4%intermediate to Gentamicin. Therefore, itwas resistant to other antibiotics within our test. Methicillin-resistantStaphylococcus were29strains, accounting for70.73%. The resistant rate ofStaphylococcus epidermidis in Penicillin G, Erythromycin, Oxacillin, Cotrimoxazole, Clindamycin, Ciprofloxacin and levofloxacin were in differentdegrees. However, Staphylococcus epidermidis was12.2%resistant and19.5%intermediate to levofloxacin, whose resistance was the lowest.Conclusion：1In the research, the same bacteria species was detected in meibomiangland secretions and conjunctival sac, which was Staphylococcus epidermidisof CNS.2Anerdian III skin and mucosa disinfectant is better than thephysiological saline between two of them.3Staphylococcus epidermidis was100%susceptible to Vancomycin,Teicoplanin, Minocycline and Linezolid, which was97.6%susceptible and2.4%intermediate to Gentamicin.4Therefore, Staphylococcus epidermidis was resistant to other antibioticswithin our test in different degrees. Methicillin-resistant Staphylococcus wasaccounting for70.73%. Staphylococcus epidermidis was12.2%resistant and19.5%intermediate to levofloxacin, whose resistance was the lowest. |
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