目的：探讨长期应用前列腺素类似物滴眼液对青光眼患者结膜菌群的影响。

方法：选择2016-06/2017-06在我院就诊的应用拉坦前列素滴眼液治疗的69例113眼青光眼患者，所有患者分别于入组后、用药3mo，1a时检查结膜菌群及表皮葡萄球菌对抗生素敏感性。

结果：入组时、用药3mo，1a时检出细菌例数分别为63、66、67例(χ²=2.496，P=0.287)。患者入组时、用药3mo，1a时表皮葡萄球菌、链球菌属、金黄色葡萄球菌、人葡萄球菌、溶血葡萄球菌、莫拉菌属等检出率均无差异(P>0.05)； 用药3mo时耐甲氧西林表皮葡萄球菌(MRSE)比率高于入组时(χ²=3.063，P=0.062)，用药1a时MRSE比率高于入组时和用药3mo时(χ²=38.945、24.984，均P<0.001)。用药3mo时表皮葡萄球菌对左氧氟沙星、加替沙星、莫西沙星、头孢他啶、妥布霉素、头孢甲肟、红霉素的敏感性均低于入组时，但无差异(P>0.0167)，对氯霉素敏感性低于入组时(P<0.0167)； 用药1a时表皮葡萄球菌对左氧氟沙星、加替沙星、莫西沙星、头孢他啶、头孢甲肟、妥布霉素、氯霉素、红霉素敏感性低于入组时和用药3mo时(P<0.0167)。

结论：长期应用拉坦前列素滴眼液不会影响结膜菌群的检出率，但可增加MRSE的发生率，临床对需要长期应用拉坦前列素滴眼液的患者应综合考虑，防止耐药菌株产生，以防发生不可控制的感染。

METHODS: Totally 69 patients(113 eyes)with glaucoma treated with latanoprostaglandin from June 2016 to June 2017 were selected, and the sensitivity of conjunctival flora and staphylococcus epidermidis to antibiotics was examined after admission, 3mo and 1a.

RESULTS: The number of bacterial eyes detected at admission, 3mo and 1a were 63, 66 and 67 respectively(χ²=2.496, P=0.287). There was no difference in the detection rates of staphylococcus epidermidis, streptococcus, staphylococcus aureus, staphylococcus hominis, staphylococcus hemolyticus and moraxella at the time of admission, 3mo and 1a(P>0.05). The ratio of MRSE at 3mo was higher than that at entry(χ²=3.063, P=0.062). The ratio of MRSE at 1a was higher than that at 3mo(χ²=38.945, 24.984, all P<0.001). The susceptibility of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, tobramycin, cefmethime and erythromycin at 3mo was lower than that at the time of admission, but there was no difference(P>0.0167), while the susceptibility of staphylococcus epidermidis to chloramphenicol at 3mo was lower than that at entry(P<0.0167). The sensitivity of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, cefmethime, tobramycin, chloramphenicol and erythromycin at 1a was lower than that at 3mo(P<0.0167).

CONCLUSION: The long-term application of latanoprostaglandin will not affect the detection rate of conjunctival flora, but can increase the incidence of MRSE. Clinically, patients who need long-term application of latanoprostaglandin should be considered comprehensively to prevent the emergence of drug-resistant strains in order to prevent uncontrollable infection.