MRSA葡萄球菌烫伤样皮肤综合征的临床特点分析  

Clinical characteristics of MRSA staphylococcal scalded skin syndrome

作　　者：邱建玲 黎雯 符艺影 邢东文 孙建华 QIU Jian-ling;LI Wen;FU Yi-ying;XING Dong-wen;SUN Jian-hua(Haikou Third People's Hospital,Haikou, Hainan 571100, China)

机构地区：[1]海口市第三人民医院皮肤科,海南海口571100 [2]海南省第五人民医院皮肤外科,海南海口570206 [3]海口市第三人民医院儿科,海南海口571100 [4]烟台市芝罘区妇幼保健院,山东烟台264001

出　　处：《中华医院感染学杂志》2019年第13期2020-2023,共4页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(2014812178)

摘　　要：目的探讨耐甲氧西林金黄色葡萄球菌(MRSA)葡萄球菌烫伤样皮肤综合征的临床特点及预后。方法选择医院于2010年1月-2018年6月收治的葡萄球菌烫伤样皮肤综合征患儿180例作为研究对象。所有研究对象进行创面分泌物或咽拭子细菌培养;采用纸片扩散法进行药敏试验。结果 MRSA阳性组发热、口周放射状皲裂和松弛性水疱多于无MRSA阳性组,且有统计学差异(P<0.05);MRSA阳性与无MRSA阳性睑结膜炎、褶皱部红斑糜烂、皮肤触痛和淋巴结肿大比较无统计学差异。MRSA阳性组白细胞上升、心肌酶升高和血液培养阳性高于无MRSA阳性,且有统计学差异(P<0.05)。MRSA药敏试验结果,对青霉素G、红霉素、苯唑西林耐药率较高,而对万古霉素无耐药率。结论 MRSA葡萄球菌烫伤样皮肤综合征的临床上以发热、口周放射状皲裂和松弛性水疱为主,且白细胞上升、心肌酶升高和血液培养阳性,及预后不良。OBJECTIVE To explore the clinical characteristics and prognosis of methicillin-resistant Staphylococcus aureus(MRSA) scalded skin syndrome. METHODS A total of 180 children with staphylococcal scalded skin syndrome who were treated in hospitals from Jan 2010 to Jun 2018 were recruited as the study objects, the wound secretions and throat swab specimens were collected from all of the study objects and cultured, and the drug susceptibility testing was performed by using disk diffusion method. RESULTS The children who had fever, perioral radial chapped and flaccid blisters were more in the MRSA-positive group than in the MRSA-negative group(P<0.05). There were no significant differences in the eyelid conjunctivitis, erythema erosion in wrinkles, skin tenderness and lymphadenopathy between the MRSA-positive group and the MRSA-negative group. The levels of white blood cells and myocardial enzymes as well as positive rate of blood culture were significantly higher in the MRSA-positive group than in the MRSA-negative group(P<0.05). The result of drug susceptibility testing showed that the drug resistance rates to penicillin G, erythromycin and oxacillin were high, while the drug resistance rate to vancomycin was 0. CONCLUSION Fever, perioral radial chapped and flaccid blisters are the major clinical manifestations of the children with MRSA staphylococcal scalded skin syndrome, the levels of white blood cells, myocardial enzymes and positive rate of blood culture are high, and the children have unfavorable prognosis.

关 键 词：耐甲氧西林金黄色葡萄球菌 葡萄球菌烫伤样皮肤综合征 临床特点 预后 

分 类 号：R753[医药卫生—皮肤病学与性病学]