656例自身免疫性大疱病住院患者皮肤感染的危险因素及病原学分析  

Clinical features and etiological analysis of skin infection in 656 hospitalized patients with autoimmune bullous disease

作　　者：姚香君 张琪 王婷[1] 范敏[1] 罗镇 王培光[1] 王再兴[1] YAO Xiangjun;ZHANG Qi;WANG Ting;FAN Min;LUO Zhen;WANG Peiguang;WANG Zaixing(Department of Dermatology,The First Affiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第一附属医院皮肤科,安徽合肥230000

出　　处：《中国麻风皮肤病杂志》2021年第8期494-498,共5页China Journal of Leprosy and Skin Diseases

摘　　要：目的:总结自身免疫性大疱病住院患者皮肤感染的相关因素、病原体以及药物敏感特征。方法:收集2013-2019年自身免疫性大疱病住院患者的临床资料,并对其感染相关因素以及皮肤感染病原体、药物敏感试验进行回顾性分析。结果:共656例自身免疫性大疱病住院患者纳入分析,皮肤感染率为74.29%,住院时长≥14天与<14天患者的感染率分别为39.51%和31.07%(P<0.05),黏膜受累者与未受累者感染率分别为42.20%和33.26%(P<0.05),合并糖尿病者与不合并糖尿病者感染率分别为46.43%和33.08%(P<0.01)。皮肤感染主要病原菌是金黄色葡萄球菌(37.68%)。对复方新诺明(93.46%)、万古霉素(99.35%)、利奈唑胺(100%)的敏感度高。革兰氏阴性菌中肺炎克雷伯菌排在首位(20.00%)。耐甲氧西林金黄色葡萄球菌(MRSA)、革兰氏阴性菌和真菌的总体占比呈逐年上升趋势。结论:自身免疫性大疱病患者容易并发皮肤感染。皮肤感染率与住院时长、累及黏膜、合并糖尿病等因素具有一定的相关性。最常见的皮肤感染病原菌是金黄色葡萄球菌。Objective:To summarize the skin infection related factors,pathogens and drug sensitivity of hospitalized patients with autoimmune bullous disease.Methods:The clinical data of patients with autoimmune bullous disease from 2013 to 2019 were collected,and their infection-related factors,skin infection pathogens,and drug sensitivity tests were retrospectively analyzed.Results:A total of 656 hospitalized patients with autoimmune bullous disease were included,the rate of infection was 74.29%.The infection rate was 39.51%and 31.07%in the patients with hospital stay over 14 days and within 14 days respectively(P<0.05).The infection rate was 42.20%and 33.26%in the patients with mucosal involvement and with no mucosal involvement respectively(P<0.05).The infection rate was 46.43%and 33.08%in the patients with diabetes and with no diabetes respectively(P<0.05).The main pathogen of skin infections was Staphylococcus aureus(37.68%).There was a high sensitivity for sulfamethoxazole(93.46%),vancomycin(99.35%)and linezolid(100%).Klebsiella pneumoniae was the most common gram-negative bacteria(20.00%).The overall proportion of MRSA,gram-negative bacteria and fungi was increasing year by year.Conclusion:Patients with autoimmune bullous disease are prone to skin infection.The skin infection rate is related to the length of hospital stay,mucosal involvement,and diabetes.The most common pathogen of skin infections is Staphylococcus aureus.

关 键 词：自身免疫性大疱病 天疱疮 大疱性类天疱疮 感染 金黄色葡萄球菌 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]