皮肤黏膜感染病原菌的种类分布及耐药性探讨  

Distribution and antimicrobial resistance of pathogenic bacteria causing skin and mucosa infection

作　　者：王顺[1] 王永涛[1] 贾征夫[1] 

机构地区：[1]武汉市第一医院检验科,湖北武汉430022

出　　处：《中华医院感染学杂志》2014年第23期5766-5768,共3页Chinese Journal of Nosocomiology

基　　金：武汉市卫计委科研基金资助项目(WX11C05)

摘　　要：目的探讨皮肤黏膜感染病原菌的种类构成比及耐药性,为临床医师诊治皮肤黏膜感染选择敏感的抗菌药物提供实验室参考依据。方法 2011年1月-2013年6月医院皮肤黏膜感染患者的脓液或创面分泌物培养得到366株病原菌,病原菌培养与种型鉴定严格按照原卫生部临检中心规定的临床微生物检验规范进行试验操作;采用CLSI指定的K-B法和折点进行敏感、中介、耐药的判读确认;采用WHONET 5.5进行数据分析。结果共检出革兰阳性菌198株占54.1%,革兰阴性菌136株占37.2%,真菌32株占8.7%;耐甲氧西林葡萄球菌分离率达到34.1%,产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌分离率达到46.2%,耐亚胺培南的铜绿假单胞菌分离率达到11.5%,未发现耐糖肽类抗菌药物革兰阳性菌,链球菌属对常用抗菌药物敏感性较高。结论皮肤黏膜感染病原菌的耐药性也十分严重,为提高临床治疗效果,临床医师应加强病原学培养的观念,依据病原菌药敏试验结果,针对性的选择敏感性强、经济合理的抗菌药物来治疗皮肤黏膜感染。OBJECTIVE To investigate constituent ratio and antimicrobial resistance of pathogenic bacteria causing skin and mucosa infection to provide the scientific evidence for clinically reasonable use of antibiotics .METHODS Totally 366 pathogenic bacteria were isolated from purulent secretion and wound drainage fluid of patients with skin and mucosa infection .Referring to National Guide to Clinical Laboratory Procedures ,bacterial culture and i‐dentification were performed .The drug susceptibility testing for sensitivity ,intermediacy ,and resistance was per‐formed by KB method and break point recommended by CLSI .The susceptibility testing results were assessed with the software WHONET 5 .5 .RESULTS The isolating rate of gram‐positive bacteria （198 strains ,54 .1% ） was the highest .Gram‐negative bacteria （136 strains ,37 .2% ） ranked the second .Fungi （32 strains ,8 .7% ） ranked the third .The susceptibility testing results showed the isolating rate of methicillin‐resistant Staphylococcus aureus （MRSA） was up to 34 .1% ,ESBLs‐producing Escherichia coli and K lebsiella pneumoniae up to 46 .2% , Imipenem‐resistant Pseudomonas aeruginosa （IRPA） up to 11 .5% .No glycopeptide‐resistant gram positive bacte‐ria were found in our hospital . Streptococcus remained higher sensitivity against commonly used antibiotics . CONCLUSION At present ,resistance of pathogenic bacteria causing infection of skin and mucosa membrane is very severe .In order to improve the clinical therapeutic effect ,the clinician should strengthen the etiological examina‐tion and choose the antibiotics reasonably to treat skin and mucosa membrane infection according to bacterial cul‐ture and susceptibility testing results .

关 键 词：皮肤黏膜 化脓性感染 病原菌 耐药性 检测 

分 类 号：R378[医药卫生—病原生物学]