白内障術後遅発性眼内炎における菌検出のための検体採取部位

Optimum site to collect samples for culture in late-onset endophthalmitis after cataract surgery

要約　目的：白内障術後に発症した遅発性眼内炎の起因菌を検出するための検体採取部位の検討。対象と方法：79歳男性，73歳女性，86歳女性の3例3眼を対象とした。眼内炎は，白内障手術のそれぞれ6か月，3か月，4か月後に発症した。検体は前房水，水晶体囊，眼内レンズ，硝子体液，手術時の灌流貯留液から採取し，好気培養と嫌気培養を行った。水晶体囊は塗抹標本としても検索した。結果：起因菌として，1例で硝子体液の嫌気培養のみでPropionibacterium acnes，2例で水晶体囊の嫌気培養のみでP. acnesとコアグラーゼ陰性ブドウ球菌が検出された。水晶体囊の塗抹標本には多数の起因菌が確認された。結論：白内障術後に遅発した眼内炎での起因菌の検出では，水晶体囊からの検体採取が第一選択である。

Abstract.　Purpose：To discuss the optimum site for sampling to detect causative microorganism in late-onset endophthalmitis after cataract surgery. Cases and Method：This study was made on 3 eyes of 3 patients, comprising 79-year-old male, 73-year-old female and 86-year-old female. Endophthalmitis developed 6, 3 and 4 months respectively after cataract surgery. Samples for aerobic and anaerobic culture were obtained from the aqueous, lens capsule, intraocular lens, vitreous, and irrigation fluid. The lens capsule was also examined as smear. Results：Causative microorganism was identified by anaerobic culture from the vitreous only in one eye and from lens capsule only in 2 eyes. Lens capsule showed numerous organisms when examined as smear. Conclusion：Lens capsule appears to be the optimum site to collect samples to detect causative organism in late-onset endophthalmitis after cataract surgery.