171例皮肤及软组织感染住院患者病原菌分布及用药情况  

Distribution of pathogens isolated from 171 hospitalized patients with skin and soft tissue infection and status of medication

作　　者：刘灵灵 刘晓丽 章晨 梁文馨 蔡芸[1] LIU Ling-ling;LIU Xiao-li;ZHANG Chen;LIANG Wen-xin;CAI Yun(Chinese PLA General Hospital,Beijing 100853,China;不详)

机构地区：[1]中国人民解放军总医院医疗保障中心药剂科药物临床研究室,北京100853 [2]中国人民解放军总医院研究生院,北京100853 [3]中国人民解放军总医院第一医学中心皮肤科,北京100853

出　　处：《中华医院感染学杂志》2023年第16期2488-2492,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(82073894);解放军总医院新药临床研究基金资助项目(4246Z512)。

摘　　要：目的 探讨及分析皮肤及软组织感染患者用药情况,为临床合理用药提供理论依据。方法 回顾性收集2021年11月-2022年11月因皮肤及软组织感染入院的患者临床资料;统计患者送检标本病原菌分布特征及药敏试验结果;调查并评估患者用药情况。结果 171例患者送检标本中培养出168株病原菌,主要优势菌为革兰阳性菌,其中金黄色葡萄球菌占比最高,其次是表皮葡萄球菌;这两种菌对万古霉素完全敏感,但对青霉素的耐药率较高(>80.00%);首选药物多以β-内酰胺类药物为主,且二代头孢、三代头孢及青霉素类最为常用。结论 革兰阳性菌为院内皮肤及软组织感染(SSTIs)的主要病原体,不同病原体对于抗菌药物的耐药性不同,可综合该地区基本情况,结合患者病原菌培养及药敏试验结果,并根据患者的病情严重程度、基础疾病,药物耐受程度等制定个体化给药方案。OBJECTIVE To explore the status of use of drugs by the patients with skin and soft tissue infection so as to provide theoretical basis for reasonable clinical use of drugs.METHODS The clinical data were retrospectively collected from the patients who were hospitalized due to skin and soft tissue infection from Nov 2021 to Nov 2022.The distribution of pathogens isolated from the submitted specimens and the result of drug susceptibility testing were statistically analyzed.The status of use of drugs was investigated and evaluated.RESULTS Totally 168 strains of pathogens were isolated from the submitted specimens of the 171 patients,gram-positive bacteria were dominant among the pathogens,Staphylococcus aureus took the highest proportion,followed by Staphylococcus epidermidis.The two species of pathogens were completely sensitive to vancomycin,while the drug resistance rates to penicillin were more than 80.00%.β-lactams were the preferred drugs,and the second generation cephalosporins,third generation of cephalosporins and penicillin were the most commonly used antibiotics.CONCLUSION The gram-positive bacteria are dominant among the pathogens isolated from the patients with skin and soft tissues infection.The pathogens vary in the drug resistance.Individualized administration regimens are formulated based on severity of illness,underlying diseases and drug tolerance degree in combination with the results of culture and drug susceptibility testing.

关 键 词：皮肤及软组织感染 病原菌 耐药率 合理用药 抗菌药物 药物利用指数 

分 类 号：R378[医药卫生—病原生物学]