感染相关皮肤病的细菌多样性及耐药性  

Preliminary analyses on bacterial diversity and resistance in infection-related skin disorders

作　　者：蒋丽潇[1] 李东明[1] 尚盼盼[1] 孙婷婷[1] 肖秀美[2] 

机构地区：[1]北京大学第三医院皮肤科,100191 [2]北京大学第三医院检验科,100191

出　　处：《中华医学杂志》2015年第22期1762-1764,共3页National Medical Journal of China

摘　　要：目的 了解感染相关皮肤病细菌多样性及其耐药性.方法 回顾性分析2010年3月至2011年5月北京大学第三医院皮肤科临床拟诊为皮肤细菌感染或继发细菌感染且标本细菌培养阳性的54例患者资料.标本来自皮损痂皮或组织、血液、脓液、渗出液等.应用VITEKⅡ全自动细菌鉴定仪进行细菌鉴定,K-B法进行药敏试验,结果按CLSI-M100.S21标准判读.结果 54例患者共鉴定出63株细菌,分布于12个属,共22种.涉及的菌种有表皮葡萄球菌、金黄色葡萄球菌、头状葡萄球菌、人葡萄球菌、滕黄微球菌、粪肠球菌D群、甲型溶血链球菌、化脓链球菌A群、无乳链球菌、棒状杆菌属、枯草芽孢杆菌、蜡样芽胞杆菌、鲍曼不动杆菌、洛菲不动杆菌、铜绿假单胞菌、阴沟肠杆菌、放射根瘤菌、少动鞘氨醇单胞菌、干燥奈瑟菌、奈瑟菌属某些菌等.甲氧西林耐药凝固酶阴性葡萄球菌占所分离凝固酶阴性葡萄球菌的46.4％（13/28）.葡萄球菌属对氨苄西林、青霉素、阿奇霉素、头孢西丁、克林霉素、复方磺胺甲（噁）唑的耐药率分别为88.6％ （31/35）、88.6％（31/35）、68.6％ （24/35）、37.1（13/35）、28.6（10/35）、26.5（9/34）.革兰阴性杆菌对阿莫西林、丁胺卡那霉素、头孢他啶等药物较敏感.结论 皮肤细菌感染病原菌种类繁多,耐药菌株的出现或为难治性感染的重要原因.Objective To explore the bacterial diversity and resistance in infection-related skin disorders.Methods The samples of blood,pyogenic fluid,exudate and skin dander were collected from 54 outpatients of chronic and recurrent skin disease and cultured for positive pathogens in the dermatological department of Peking University Third hospital from March 2010 to May 2011.Also their drug susceptibilities were examined.Results Among 63 bacterial strains of 22 species in 12 genus,the pathogens were Staphylococcus epidermidis,Staphylococcus aureus,Micrococcus luteus,group A Streptococcus pyogenes,Staphylococcus agalactiae,Corynebacterium sp.,Bacillus subtilis,Bacillus cereus,Acinetobacter baumanii,A.lwoffii,Pseudomonas aeruginosa,Enterobacter cloacae,Rhizobium radiobacter,Sphingomonas paucimobilis,Enterococcus faecalis,Neisseria sicca and Neisseria gonorrhoeae.The percentage of methicillin-resistant coagulase negative staphylococci （MRCNS） was 46.4% （13/28） while the resistant rates of Styphylococci to ampicillin,penicillin,azithromycin,cefoxitin,clindamycin and SMZ-TMP were 88.6% （31/35）,88.6% （31/35）,68.6% （24/35）,37.1 （13/35）,28.6 （10/35） and 26.5 （9/34） respectively.Gram negative bacilli were sensitive to ampicillin,amikacin sulfate,ceftazidime.Conclusion There are a wide range of pathogenic bacterial species among refractory infection of outpatients.And drug resistance is among the reasons for refractory infections.

关 键 词：皮肤疾病 细菌性 微生物敏感性试验 抗药性 细菌 

分 类 号：R446.5[医药卫生—诊断学]