2012年浙江省麻风足底溃疡患者病原菌感染及耐药分析  

Detection of Infectious Pathogens and Their Drug Resistance in Patients with Leprosy Plantar Ulcer in Zhejiang in 2012

作　　者：陆明琴[1] 李菊红 王景权[1] 潘美儿[1] 赵建妹[1] 严良斌[3] 

机构地区：[1]浙江省皮肤病防治研究所,浙江德清313200 [2]浙江绍兴第三医院 [3]中国疾病预防控制中心麻风病控制中心

出　　处：《实用预防医学》2013年第9期1123-1126,共4页Practical Preventive Medicine

基　　金：中国-荷兰麻风病防治合作卫生系统研究项目(编号:HSR 2010-03)

摘　　要：目的调查浙江省2012年麻风足底溃疡病原菌感染及耐药情况,为临床治疗提供参考依据。方法对本所住院部部分麻风足底溃疡患者溃疡标本进行病原菌培养及耐药鉴定。结果 64例足底溃疡患者病原菌培养56例阳性,占87.5%,其中48例为1种病原菌(85.71%);6例为2种病原菌(10.71%),2例为3种及以上病原菌感染(3.58%)。最常见的感染病原菌依次为奇异变形杆菌(29.9%)、金葡菌(17.9%)、绿脓杆菌(9.0%)、摩根摩根菌(7.5%)、类白喉杆菌(6.0%)和粪产碱杆菌(6.0%)。药敏试验表明无论革兰阳性菌还是革兰阴性菌对大多数常用抗生素的耐药性均较高,但对于高档抗生素如万古霉素、头孢他啶、头孢噻肟、舒普深、亚胺培南、氨曲南尚保持较高的敏感性。结论麻风病足底溃疡病原菌感染比较常见,对于常用抗生素的耐药性增加,建议在临床使用抗生素时应重视病原菌培养和药敏试验,合理使用抗生素,减少耐药发生,并配合以溃疡足的制动休息。Objective To investigate the infectious pathogens and drug resistance modality among patients with leprosy plantar ulcer in Zhejiang province in 2012, and provide evidence for rational use of antibiotics. Methods We cultivated 64 specimens collected from leprosy plantar ulcer patients who were hospitalized in Institute of Dermatology of Zhejiang province, and then antibiotic sensitivity test was made in positive pathogens. Results Fifty- six specimens yielded organisms, account- ed for 87.5 % （56/64）. Single organism was isolated in 48 cases （85.71% ）, two organisms were isolated in 6 cases （ 10.71% ）, and three or more organisms were isolated in 2 cases （3.58 % ）. Proteus mirabilis （29.9 % ）, Staphylococcus aureus （ 17.9 % ）, Pseudomonas aeruginosa （ 9.0 % ）, Morganella morganii （ 7.5 % ）, Diphtheroid bacilli （ 6.0 % ）, and Alcaligenes faecaIis （6.0 % ） were the predominant organisms in these cultivations. In this study, both gram- positive and gram - negative bacteria showed a lower sensitivity to most antimierobial agents tested. But they were all highly sensitive to advanced antibiotics like van- comycin, ceftazidime, eefotaxime, cefoperazone sodium, imipenem, and aztreonam. Conclusion Pathogen infection is com- mon in leprosy plantar ulcer and the antibiotic resistance is increased in cultivated organisms. The use of antibiotics should he based on the results of pathogen cultures and drug susceptibility testing in control of leprosy plantar ulcer; moreover, keeping feet at rest should be also important.

关 键 词：麻风病 足底溃疡 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]