細菌（真菌）性眼内炎の動向—発症動機と起炎菌

Changing trends of bacterial and fungal endophthalmitis. Etiological features

　過去20年間の細菌（真菌）性眼内炎77症例について，発症動機と起炎菌の動向を調べた。

　症例の内訳は外傷性（32例），手術性（26），転移性（19）で，各々の年次推移は減少，不変，増加の傾向であった。47例で前房水か硝子体の培養がなされ，27例から起炎菌が分離された。前房水，硝子体からの培養陽性率は各々26.3％，61.3％であった。起炎菌の全体はグラム陽性菌（17），グラム陰性菌（12），真菌（2）で，Coagulase Negative　staph （6），E．coli （5），Klebsiella pneumoniae （3），Staph．aureus, Strept．　faecalis, Ps．　aeruginosa，　Candida （2），その他の順で多かった。発症動機別では外因性（外傷・手術）はCoagulase negative　staph　（6）を筆頭としてグラム陽性菌が優位，内因性は　E．　coli　（4），　Klebsiella pneumoniae　（3），Candida （2）などでグラム陰性菌が優位であった。

　今後，漸増する内因性のグラム陰性杆菌および真菌性眼内炎の動向に注意を要する。

We reviewed a consecutive series of 77 cases of bacterial or fungal endophthalmitis during the past 20-year period. Foregoing penetrating trauma was responsible for 32 cases, surgery for 26 cases, and metastasis from foci elsewhere for 19 cases.

Isolation of causative organism from the aque-ous or the vitreous was positive in 27 out of 47 cases examined. The rate of positive isolation was 26%from the aqueous and 61%from the vitreous. A wide range of organisms were isolated, including coagulase-negative staphylococci in 6 cases, E. coli in 5, Klebsiella pneumoniae in 3, Staphylococcus aureus in 2, Streptococcus faecalis in 2, Pseudomonas aeruginosa in 2, Candida in 2 and others.

Exogenous, or trauma or surgery-induced, cases, were mainly caused by Gram-positive bacteria, led by coagulase-negative staphylococcus in 6. En-dogenous cases were mainly due to Gram-negative bacteria including E. coli in 4 and Klebsiella pneumoniae in 3.

We observed an increased trend of endogenous infection due to Gram-negative bacteria and fun-gus in recent years.