寻常型银屑病患者皮损处合并细菌感染的病原菌分布特征及耐药性分析  

An Analysis of Pathogenic Bacteria Distribution and Drug Resistance in Psoriasis Vulgaris Patients with Bacterial Infection

作　　者：马红叶 高翔[1] 汪轩羽 李天骄 张彤[2] 冯暄 刘荣奇[3] 郭宏林[1] MA Hongye;GAO Xiang;WANG Xuanyu;LI Tianjiao;ZHANG Tong;FENG Xuan;LIU Rongqi;GUO Honglin(Department of Clinical Laboratory,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010;Capital Medical University,Beijing 100069;Department of Dermatology,Beijing Hospital ofTraditional Chinese Medicine,Capital Medical University,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院检验科,北京100010 [2]首都医科大学中医药临床医学院,北京100069 [3]首都医科大学附属北京中医医院皮肤科,北京100010

出　　处：《标记免疫分析与临床》2024年第7期1193-1198,共6页Labeled Immunoassays and Clinical Medicine

基　　金：首都医科大学本科生科研创新项目(编号:XSKY2024537)。

摘　　要：目的探讨寻常型银屑病患者皮损处细菌感染主要病原菌构成以及对抗菌药物的耐药性,指导临床合理使用抗生素。方法收集2021年1月至2023年12月首都医科大学附属北京中医医院皮肤科住院送检的154例寻常型银屑病患者皮损处分泌物标本,分离出的菌株采用VITEK 2 Compact全自动微生物鉴定及其药敏分析系统进行细菌鉴定及药敏实验,分析检出的病原菌分布特点及药敏结果。结果寻常型银屑病患者共分离鉴定出病原菌154株,其中121株革兰阳性菌,占78.57%,30株革兰阴性菌,占19.48%,主要菌株为金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌及铜绿假单胞菌;金黄色葡萄球菌对青霉素耐药率较高,达80.82%,表皮葡萄球菌对青霉素、左氧氟沙星耐药率较高,分别为86.96%、73.91%,溶血葡萄球菌对环丙沙星、左氧氟沙星、青霉素高度耐药,均为100%,铜绿假单胞菌对喹诺酮类、氨基糖苷类、碳青霉烯类、头孢类抗生素均未呈现出耐药现象;73株金黄色葡萄球菌中耐甲氧西林的金黄色葡萄球菌(MRSA)检出率10.96%(8/73)。结论寻常型银屑病患者皮损处细菌感染的病原菌以金黄色葡萄球菌、表皮葡萄球菌等革兰氏阳性细菌为主,对青霉素、左氧氟沙星耐药率较高,伴随一定比例的MRSA感染。Objective To investigate major components of pathogenic bacteria distribution and antibiotic resistance of psoriasis vulgaris patients with bacterial infection,so as to guide the clinical rational use of antibiotics.Methods A total of 154 secretions from skin lesions of psoriasis vulgaris patients who were hospitalized in the Department of Dermatology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University from January,2021 to December,2023 were selected as the study subjects.The isolated strains were identified and tested by VITEK 2 compact automatic microbial identification and drug sensitivity analysis system.The characteristic distributions of pathogenic bacteria and drug susceptibility test results were analyzed.Results A total of 154 strains of pathogenic bacteria were isolated from psoriasis vulgaris patients with skin infection,of which 78.57%were Gram-positive bacteria,while 19.48%were Gram-negative bacteria.The main separated strains were Staphylococcus aureus,Staphylococcus epidermis,Staphylococcus haemolyticus and Pseudomonas aeruginosa.The resistance rate of Staphylococcus aureus to penicillin was 80.82%,while the resistance rate of Staphylococcus epidermidis to penicillin and levofloxacin were 86.96%and 73.91%,respectively,and the resistance rate of staphylococcus hemolyticus to ciprofloxacin,levofloxacin and penicillin was 100%.Pseudomonas aeruginosa showed no resistance to quinolones,aminoglycosides,carbapenems and cephalosporins.The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)in 73 strains of Staphylococcus aureus was 10.96%.Conclusion Gram-positive bacteria,especially Staphylococcus aureus and Staphylococcus epidermidis,are the main pathogenic bacteria of psoriasis vulgaris patients with bacterial infection,and the resistance rate to penicillin and levofloxacin is high,generally accompanied by a certain proportion of MRSA infection.

关 键 词：寻常型银屑病 病原菌 耐药性 抗生素 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]