葡萄球菌烫伤样皮肤综合征208例临床分析  

Clinical Analysis of 208 Cases of Staphylococcal Scalded Skin Syndrome

作　　者：张霞[1] 马琳[1] 刘盈[1] 

机构地区：[1]首都医科大学附属北京儿童医院皮肤科,北京100045

出　　处：《中国皮肤性病学杂志》2010年第6期525-527,共3页The Chinese Journal of Dermatovenereology

基　　金：北京自然科学基金资助项目(762023);北京市优秀人才培养资助个人项目(20051A0300823);北京市卫生系统高层次卫生技术人才项目(2009-3-39)

摘　　要：目的回顾分析208例葡萄球菌烫伤样皮肤综合征患儿的临床资料,对部分病原菌进行表皮剥脱毒素及药敏检测,了解本地区致病菌分泌表皮剥脱毒素血清型别及药敏情况。方法记录所有病例的临床资料,并对其中30株金黄色葡萄球菌(以下简称SA)应用反向乳胶凝集法检测表皮剥脱毒素,对51株SA应用琼脂稀释法进行了14种抗生素的药敏试验。结果 30株SA中,21株表皮剥脱毒素A,B均阳性,8株单纯表皮剥脱毒素B阳性。51株SA药敏青霉素耐药率为96.08%,对红霉素耐药率为82.35%。对苯唑青霉素、头孢类抗生素、莫匹罗星、万古霉素和夫西地酸均未发现耐药菌。结论引起本病的SA以表皮剥脱毒素A,B均阳性的菌株为主。青霉素和红霉素耐药率较高,不适合治疗本病。头孢菌素、万古霉素和夫西地酸可作为可选择的抗生素。Objective In order to study the antibiotic susceptibility and identify the serotype of exfoliative toxins to some Staphylococcus aureus isolates, two hundred and eight patients with staphylococcal scalded skin syndrome （SSSS）were analyzed. Methods Admission records of patients managed for SSSS were retrieved from the medical records. Staphylococcus aureus （S. aureus） , isolated from 51 patients were subjected to antibiotic susceptibility test by using agar dilution method. Another 30 S. aureus strains were detected the serotype type of exfoliative toxin（ET） by using reverse latex agglutination. Results Of the 30 strains detected S. aureus, 21 could product ETA and ETB together and 8 could product ETB alone. 96.08% strains were resistant to Penicillin and 82.35% to Erythromycin. None of the S. aureu strains were resistant to oxaclin, cephalosporins, mupirocin, vancomycin or fusidic acid. Conclusion The most cansitive S. aureus isolates can product ETA and ETB together. Penicillin and erythromycin are no longer appropriate agents. Effective antibiotic agents for patients with SSSS are cephalosporins, vancomycin and fusidic acid.

关 键 词：葡萄球菌烫伤样皮肤综合征 表皮剥脱毒素 金黄色葡萄球菌 药敏 

分 类 号：R753[医药卫生—皮肤病学与性病学]