寻常痤疮与正常人皮肤微生物的对比  

The Comparative Study of Acne Vulgaris and Normal Skin Microorganisms

作　　者：何丽莎[1] 路永红[1] 高诗燕[1] 周培媚[1] 卞彩云[1] 蒋存火[1] 吴波[1] 陈前明[1] 王珊珊[1] 保勇[1] 吕艳[1] 尹亚非[1] 陆玲[1] 

机构地区：[1]成都市第二人民医院皮肤科,四川成都610017

出　　处：《中国皮肤性病学杂志》2017年第4期378-382,共5页The Chinese Journal of Dermatovenereology

基　　金：四川省卫生厅课题项目(120549)

摘　　要：目的探讨寻常痤疮与正常人皮肤表面微生物的差异及细菌耐药性问题,为痤疮的病原学研究及痤疮的抗生素治疗提供科学的理论依据。方法对寻常痤疮面部皮损内容物及正常人面部皮肤表面进行细菌培养、分离及鉴定。对培养出细菌分别进行体外抗生素药物敏感试验。结果 137例寻常痤疮面部皮损中细菌总检出率高于89例正常人面部皮肤。144例寻常痤疮中有137例面部皮损中分离出细菌306株(阳性率95.14%)。主要是痤疮丙酸杆菌102株(33.33%)、表皮葡萄球菌95株(31.05%)。96例正常人中有89例面部皮肤表面分离出223株细菌(阳性率92.71%)。主要是痤疮丙酸杆菌67株(30.04%)、表皮葡萄球菌44株(19.73%)。寻常痤疮及正常人皮肤表面均未分离出念珠菌;痤疮丙酸杆菌对抗生素的耐药率寻常痤疮患者高于正常人,耐药率前2位为:甲硝唑,克林霉素;表皮葡萄球菌对抗生素的耐药率寻常痤疮患者高于正常人。耐药率前5位依次为青霉素、红霉素、克林霉素、复方新诺明、苯唑西林。结论寻常痤疮皮损中主要细菌是以痤疮丙酸杆菌及表皮葡萄球菌混合感染常见。治疗寻常痤疮时应避免使用甲硝唑、青霉素、红霉素、克林霉素。可选择米诺环素、喹奴普汀、万古霉素、呋喃妥因。Objective To investigate the difference of the skin surface microorganisms and bacteriasl resistance between acne vulgaris and normal people, and to provide a scientific basis for antibiotic treatment and the etiology study of acne.Methods Solation and identification of bacterias from the contents of the acne vulgaris lesions and healthy facial skinwere processed. We did antibiotics sensitivity test in vitro for the bacterias.Results The total bacterias detection rate of acne vulgaris（n=137）is higher than that of normal human facial skin（n=89）. 306 strains of bacterias were isolated from 137 cases out of 144 patients with acne vulgaris（95.14%）. The main advantage bacterias were 102 strains of Propionibacterium Acnes（33.33%）, 95 strains of Staphylococcus Epidermidis（31.05%）. Two hundreds and twenty-three strains of bacterias were isolated from 89 cases in 96 healthy people facial skin（92.71%）. The main advantage bacterias were 67 strains of Propionibacterium Acnes（30.04%）, 44 strains of Staphylococcus Epidermidis（19.73%）. The Candida was not isolated from acne vulgaris and normal skin surface. The resistant rate of P.Acnes isolated from acne vulgaris to antibiotics susceptibility test in vitro is higher than that of normal people,furthermore,Metronidazole and Clindamycin were listed in the firest and second place.The resistance rate of Staphylococcus Epipermidis to antibiotics susceptibility test in vitro was higher than that of normal people. Moreover, the top five resistance rates are Penicillin, Erythromycin, Clindamycin, Cotrimoxazole and Oxacillin. Conclusion The main detected baterias from acne vulgaris facial skin lesions are mainly Propionibacterium Acnes and Staphylococcus Epidermidis, morover mixed infection is common.The treatments should avoid using Metronidazole, Penicillin, Erythromycin, Clindamycin, can use Minocyclin, Quinupristin, Vancomycin, Nitrofurantoin.

关 键 词：寻常痤疮 痤疮丙酸杆菌 表皮葡萄球菌 颗粒丙酸杆菌 头状葡萄球菌 药物敏感试验 

分 类 号：R758.733[医药卫生—皮肤病学与性病学]