皮肤病住院患者合并菌血症常见致病菌及临床特征  

Analysis of common pathogenic bacteria and clinical characteristics of dermatosis inpatients complicated with bacteremia

作　　者：李园园 杨庆琪 王姗姗 董海玲 邵丽芳 杜明梅[2] LI Yuan-yuan;YANG Qing-qi;WANG Shan-shan;DONG Hai-ling;SHAO Li-fang;DU Ming-mei(Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心皮肤科,北京100142 [2]解放军总医院第一医学中心疾病预防控制科,北京100853

出　　处：《中华医院感染学杂志》2020年第12期1856-1859,共4页Chinese Journal of Nosocomiology

基　　金：国家科技重大专项基金资助项目(2018ZX10733-402)。

摘　　要：目的分析皮肤科住院患者合并菌血症的疾病类型、病原菌、临床特征、治疗及转归。方法对2011年1月-2019年12月空军特色医学中心皮肤科收治的42例合并菌血症患者的临床资料进行回顾性分析。结果合并菌血症常见皮肤病为红皮病(42.86%)、脓疱型银屑病(16.67%)和嗜酸性粒细胞增多性皮肤病(9.52%)。42例菌血症共检出54株致病菌,其中革兰阳性菌49株占90.74%,以金黄色葡萄球菌和表皮葡萄球菌为主;革兰阴性菌5株占9.26%。金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(Methicillin resistant staphylococcus aureus,MRSA)检出率为20.00%,所有革兰阳性菌对万古霉素、替加环素、利奈唑胺100.00%敏感。选择万古霉素和喹诺酮类抗菌药物治疗多见,同时积极治疗皮肤病,治疗有效率为92.86%。结论皮肤科住院患者合并菌血症以革兰阳性菌为主,耐药性较低,预后较好。OBJECTIVE To analyze the disease types,pathogenic bacteria,clinical characteristics,treatment and outcome of dermatosis inpatients complicated with bacteremia.METHODS The clinical data of 42 patients with bacteremia who were admitted to the Dermatology Department of Air Force Specialized Medical Center from Jan.2011 to Dec.2019 were retrospectively analyzed.RESULTS The common skin diseases associated with bacteremia were erythroderma(42.86%),pustular psoriasis(16.67%),and hypereosinophilic dermatitis(9.52%).A total of 54 strains of pathogenic bacteria were isolated from the 42 cases of bacteremia,including 49 strains of Gram-positive bacteria accounting for 90.74%,mainly Staphylococcus aureus and Staphylococcus epidermidis;5 strains of Gram-negative accounting for 9.26%.The detection rate of methicillin resistant S.aureus(MRSA)in S.aureus was 20%.All Gram-positive bacteria were 100%sensitive to vancomycin,tigacycline and linezolid.The common drugs chosen for antibacterial treatment were vancomycin and quinolones.At the same time,skin diseases were actively treated,the effective rate of treatment was 92.86%.CONCLUSION Dermatology inpatients complicated with bacteremia were dominated by gram-positive cocci,with low drug resistance and a good prognosis.

关 键 词：皮肤病 菌血症 致病菌 临床特征 

分 类 号：R753[医药卫生—皮肤病学与性病学]