葡萄球菌性烫伤样皮肤综合征表皮剥脱毒素分型及耐药分析  

The Exfoliative Toxin Serotypes and Resistance of Staphylococcal Aureus from Staphylococcal Scalded Skin Syndrome

作　　者：赵俊英[1] 王晓彦[2] 

机构地区：[1]内蒙古鄂尔多斯市中心医院皮肤科,内蒙古鄂尔多斯017000 [2]内蒙古医科大学附属医院皮肤科,内蒙古呼和浩特010050

出　　处：《中国皮肤性病学杂志》2014年第8期794-796,813,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨引起本地区46例葡萄球菌性烫伤样皮肤综合征(staphylococcal scalded skin syndrome,SSSS)患者的金黄色葡萄球菌(staphylococcus aureus,SA)所分泌的表皮剥脱毒素(exfoliative toxin,ET)血清型及SA的耐药情况,并与寻常型脓疱疮及皮肤疖肿组进行对比。方法 138株SA分离自SSSS(46株),寻常型脓疱疮(49株),皮肤疖肿组(43株)。应用多重PCR方法检测SA产生的ET类型,应用Kirby-Bauer纸片法检测SA对15种抗生素的耐药情况。结果 SSSS组SA共46株(100.00%)均产生ET,均是以单产ETB为主;寻常型脓疱疮组产生ETB的有30株(61.22%);皮肤疖肿组无一株产生ETB。138株SA均未检测到ETA或ETD的表达。三组SA分泌ET的比例差异存在统计学意义(P<0.05)。SSSS、寻常型脓疱疮及皮肤疖肿组对青霉素、红霉素、克林霉素的耐药率较高,而对一、二代头孢类抗生素较敏感。三组共发现6株耐甲氧西林金黄色葡萄球菌(MRSA)。结论内蒙古呼和浩特市地区SSSS的致病SA主要以单产ETB为主。本地区SA主要对青霉素、红霉素、克林霉素高度耐药,对一、二代头孢类抗生素较敏感。Objective To research the serotype of the exfoliative toxin in staphylococcus aureus isolated from 46 pa- tients with generalized SSSS and identifying the antibiotic resistance （ 100.00% ） of SA , then compared with impetigovulgaris and cutaneous furuncle groups. Methods One hundred and thirty-eight stains of SA were i- solated from 46 patients with SSSS, 49 patients with impetigo vulgaris and 43 patients with cutaneous furun- cle. Multiplex PCR was used to detect the staphylococcal ET serotype. The antibiotic resistance of SA to the 15 antibiotics were tested by Kirby-Bauer scrip. Results All of 46 strains（ 100.00% ） of SA from SSSS ex- pressed ETB alone. Among 49 strains of SA from impetigo vulgaris, only 30 strains（61.22% ）could product ETB. There were no ETB expression in cutaneous furuncle group. The ETA or ETD were not detected from 138 SA. There was statistical difference in the proportion of ET-producing strains in three groups （P 〈 0.05）. The ratio of SA resistant to penicillin, erythromycin and clindamycin were high among each sub- groups. While three groups of SA were sensitive to the first and second cephazolin. The strains of MRSA （Methicillin-resistant staphylococcus aureus） detected from three groups were 6 in total. Conclusion SA strains of SSSS mainly produce ETB in Hohhot in the Inner Mongolia. Drug sensitivity test in this region indi- cated that SA strains are highly resistant to penicillin, erythromycin and clindamycin, but sensitive to the first and second cephazolin.

关 键 词：金黄色葡萄球菌 葡萄球菌性烫伤样皮肤综合征 表皮剥脱毒素 药敏试验 

分 类 号：R753[医药卫生—皮肤病学与性病学]