皮肤病患者感染病原菌分布与耐药性研究  

Bacterial distribution and drug resistance of infectious pathogens in patients with skin disorders

作　　者：陈庆宁[1] 王小川[1] 杜鹏[1] 金梅[1] 樊楚明[2] 

机构地区：[1]云南省第一人民医院皮肤科,云南昆明650032 [2]云南省第一人民医院重症医学科,云南昆明650032

出　　处：《中华医院感染学杂志》2016年第3期619-621,共3页Chinese Journal of Nosocomiology

基　　金：云南省科技厅昆明医科大学联合基金资助项目(2014FZ066)

摘　　要：目的探讨皮肤病患者感染病原菌分布及其耐药性,以期为临床医师提供治疗依据。方法选取2012年1月-2015年1月在医院皮肤科治疗的皮肤病感染患者200例作为研究对象,采集患者皮损痂皮或组织、脓液、渗出液以及血液等标本进行细菌培养,采用VITEK-2进行菌种鉴定,药敏试验用K-B法,按照CLSI 2011年标准进行判定。结果 200例皮肤感染患者标本中分离出245株不同种属的病原菌,其中革兰阳性球菌、革兰阴性球菌、革兰阳性杆菌以及革兰阴性杆菌分别占65.2%,3.6%,18.7%和12.5%,革兰阳性球菌中以葡萄球菌属为主占55.3%,革兰阳性杆菌中以棒杆菌属为主占11.4%;患者皮肤感染部位以手、足以及合并感染较多,分别占13.0%、11.0%及17.0%;革兰阳性杆菌对青霉素、氨苄西林的耐药率较高,分别为64.4%、64.0%;革兰阴性杆菌对阿莫西林以及氨曲南的耐药率较高,分别为53.3%、48.3%;革兰阴性球菌对多数药物均敏感,耐药率较低。结论病原菌种类繁多以及细菌耐药性的逐渐增加,导致感染相关皮肤病患者的治疗难度加大,临床医师应根据药敏试验结果合理选用抗菌药物。OBJECTIVE To investigate the bacterial distribution and drug resistance of infectious pathogens in patients with skin disorders.METHODS Totally 200 cases of skin infections in our hospital from Jan.2012 to Jan.2015 were selected as the research subjects.Skin lesions and scabs or tissues,pus,exudate and blood specimens were collected for bacterial culture,bacterial species were identified by VITEK II,drug sensitivity test was conducted by K-B,and judgment was made according to the CLSI 2011 standard.RESULTS Totally 245 bacterial strains of different species were isolated from the 200 cases of skin infections and identified in this study,including gram positive cocci,gram negative cocci,gram positive bacilli and gram negative bacilli accounting for 65.2%,3.6%,18.7%,and 12.5%,respectively.Gram positive cocci were dominated by Staphylococcus（55.3%）,and gram positive bacilli were dominated by Corynebacterium（11.4%）.The main infected sites were hand（13.0%）and foot（11.0%）and co-infections（17.0%）were common.Gram positive bacilli had a high resistance of 64.4% to penicillin and 64.0%to ampicillin.Gram negative bacilli had a high resistance of 53.3%to amoxicillin and 48.3%to aztreonam.Gram negative cocci were sensitive to most drugs,and the drug resistance rate was low.CONCLUSION A wide range of bacterial species and the gradual increase in bacterial resistance cause the difficulty of the treatment of the infection-related skin disorders,clinicians should use antimicrobial agents according to drug sensitivity test results.

关 键 词：皮肤病 患者 感染 病原菌 耐药性 药敏试验 

分 类 号：R378[医药卫生—病原生物学]