成人细菌性皮肤病的病原菌分布与耐药性研究  

Study on the distribution and resistance of bacterial strains isolated from adult with bacterial dermatic infection

作　　者：王敏[1] 原明明[1] 李树君[1] 李和平[1] 张青叶[1] 张玉琴[1] WANG Min;YUAN Ming-ming;LI Shu-jun;LI He-ping;ZHANG Qing-ye;ZHANG Yu-qin(Dermatological Department,Gansu Provincial Hospital of TCM,Lanzhou 730050,China)

机构地区：[1]甘肃省中医院皮肤疮疡科,甘肃兰州730050

出　　处：《中国病原生物学杂志》2020年第7期846-849,共4页Journal of Pathogen Biology

基　　金：甘肃省中医药管理局科研课题(No.GZK-2013-40)。

摘　　要：目的研究成人细菌性皮肤病的病原菌分布特点与耐药性,为该病的治疗提供参考依据。方法从本院皮肤科患者感染伤口中分离258株病原菌进行相应病原菌鉴定和药敏试验,采用VITEK-AMS60微生物鉴定仪,产超广谱β-内酰胺酶菌(ESBLs)鉴定选择CLSI2013年新折点作筛选与确证;病原菌的耐药性采用K-B法,耐甲氧西林葡萄球菌的鉴定采用CLSI头孢西丁纸片法。结果分离培养得到的258株病原菌,其中革兰阳性菌168株,占65.12%;革兰阴性菌78株,占30.23%;真菌12株,占4.65%。革兰阳性菌中的金黄色葡萄球菌121株,占46.89%,凝固酶阴性葡萄球菌19株,占7.36%;革兰阴性菌中的铜绿假单胞菌32株,占12.40%,肺炎克雷伯菌21株,占8.14%,大肠埃希菌16株,占6.20%。药敏试验显示,链球菌对13种受试药物的耐药性均在20%以上。168株革兰阳性菌检出耐甲氧西林葡萄球菌98株,占58.33%;在肺炎克雷伯菌和大肠埃希菌中检出ESBLs菌80株,占31.01%;耐亚胺培南铜绿假单胞菌(IRPA)分离率为46.87%。革兰阳性球菌对糖肽类药物100%敏感,革兰阴性杆菌对磺胺类抗菌药物耐药率在56.25%及以上。结论成人皮肤病患者感染病原菌的耐药性呈现上升趋势,因此应及时进行病原菌的检查和耐药性检测,根据耐药性选择治疗药物,同时严格控制病原菌在医院和患者之间的传播。Objectives To study the distribution characteristics and drug resistance of pathogens in adult bacterial dermatosis contribute to providing reference for the treatment of the disease.Methods 258 strains of pathogens were isolated from infected wounds of dermatological patients in our hospital for pathogen identification and drug sensitivity test.VITEK-AMS60 microbiological identification instrument was used to identify extended-spectrumβ-lactamase-producing bacteria.The new break point of(ESBLs)in 2013 was selected for screening and confirmation,and the drug resistance of pathogenic bacteria was identified by K-B method and methicillin-resistant staphylococci were identified by CLS I cefoxitin disk method.Results 258 strains of pathogenic bacteria were isolated and cultured,including 168 strains of gram-positive bacteria,accounting for 65.12%,78 strains of gram-negative bacteria,accounting for 30.23%,and 12 strains of fungi,accounting for 4.65%.Among the gram-positive bacteria,121 strains were Staphylococcus aureus(46.89%),19 strains were coagulase-negative staphylococci(7.36%),32 strains were Pseudomonas aeruginosa(12.40%),21 strains were Klebsiella pneumoniae(8.14%)and 16 strains were Escherichia coli(6.20%).Drug sensitivity tests showed that the resistance of streptococci to 13 tested drugs was more than 20%.98 strains of methicillin-resistant staphylococci were detected in Gram-positive bacteria,accounting for 58.33%;80 strains of ESBLs bacteria were detected in Klebsiella pneumoniae and Escherichia coli,accounting for 31.01%;and the isolation rate of imipenem-resistant Pseudomonas aeruginosa(IRPA)was 46.87%.Gram-positive cocci were 100%sensitive to glycopeptide drugs,and the resistance rate of gram-negative bacilli to sulfonamides was 56.25%or more.Conclusion The drug resistance of pathogenic bacteria in adult patients with dermatosis is on the rise,so the examination and drug resistance detection of pathogens should be carried out in time,therapeutic drugs should be selected according to drug resistance,an

关 键 词：成人 皮肤感染 葡萄球菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]