138例皮肤肿瘤患者皮损部位细菌培养及耐药性分析  

Analysis of Bacterial Culture and Drug Resistance in Skin Lesions of 138 Patients with Skin Tumors

作　　者：徐娇 刘雯雯 周志军 邓豫豫 李世洋 徐易 李昌夏 陶小华 XU Jiao;LIU Wenwen;ZHOU Zhijun;DENG Yuyu;LI Shiyang;XU Yi;LI Changxia;TAO Xiaohua(Dermatology Hospital of Jiangxi Province,Jiangxi Provincial Clinical Research Center for Skin Diseases,Candidate Branch of National Clinical Research Center for Skin Diseases,Nanchang Jiangxi 330001,China;Nanchang University Medical College,Nanchang Jiangxi 330006,China.)

机构地区：[1]江西省皮肤病专科医院,江西省皮肤病临床医学研究中心,国家皮肤与免疫疾病临床医学研究中心分中心建设单位,江西南昌330001 [2]南昌大学医学院,江西南昌330006

出　　处：《药品评价》2024年第7期893-897,共5页Drug Evaluation

基　　金：江西省卫健委科技计划项目(202311332)。

摘　　要：目的回顾性分析138例皮肤肿瘤患者皮损部位分泌物的细菌分布和药敏检测情况,为临床合理规范使用抗菌药物提供依据,以减少耐药菌株的产生。方法本研究采用Excel和SPSS 27.0统计学软件分析江西省皮肤病专科医院2018年1月至2022年12月皮肤肿瘤住院患者皮损部位的分泌物培养、鉴定及药敏试验的数据。结果共检出141株菌株。金黄色葡萄球菌检出51株(36.17%),其中耐甲氧西林金黄色葡萄球菌(MRSA)13株(25.49%),MRSA对青霉素、苯唑西林、头孢曲松的耐药率均为100.00%,对红霉素和克林霉素耐药率为69.23%;甲氧西林敏感金黄色葡萄球菌(MSSA)38株(74.51%),对青霉素、红霉素、克林霉素耐药率分别为94.74%、39.47%、34.21%;未出现对万古霉素、利福平、利奈唑胺耐药的耐药菌株。铜绿假单胞菌检出32株(22.70%),对环丙沙星耐药率为15.63%。肺炎克雷伯菌检出16株(11.35%),对头孢唑林、甲氧苄氨嘧啶/磺胺耐药率分别为50.00%、37.50%。大肠埃希菌检出14株(9.93%),对氨苄西林、头孢唑林耐药率分别为85.71%、92.86%。结论经药敏试验后发现培养菌株对常用抗菌药物耐药发生率较高,临床应根据所鉴菌株的药敏检测情况,合理规范使用抗菌药物,有助于促进康复,改善预后,减少耐药情况的发生。Objective To retrospectively analyze the bacterial distribution and drug sensitivity test results of exudates from skin tumor lesions in 138 patients,in order to provide a basis for clinical rational and standardized use of antibacterial drugs and reduce the emergence of resistant strains.Methods The data of the exudates from skin tumor lesions of hospitalized patients with skin tumors were collected from January 2018 to December 2022 for culture,identification,and drug sensitivity testing using Excel and SPSS 27.0 statistical software.Results A total of 141 strains were detected.Staphylococcus aureus was detected in 51 strains(36.17%),of which 13 strains(25.49%)were methicillin-resistant staphylococcus aureus(MRSA),the resistance rates of MRSA to penicillin,oxacillin,cefazolin,and vancomycin were all 100.00%,and the resistance rates to erythromycin and clindamycin were 69.23%.Staphylococcus aureus susceptible to methicillin(MSSA)was detected in 38 strains(74.51%),with resistance rates of 94.74%,39.47%,and 34.21%to penicillin,erythromycin,and clindamycin,respectively.No strains were resistant to vancomycin,levofloxacin,or linezolid.Pseudomonas aeruginosa was detected in 32 strains(22.70%),with a resistance rate of 15.63%to ciprofloxacin.Klebsiella pneumoniae was detected in 16 strains(11.35%),with resistance rates of 50.00%and 37.50%to cefazolin and trimethoprim/sulfamethoxazole,respectively.Escherichia coli was detected in 14 strains(9.93%),with resistance rates of 85.71%and 92.86%to ampicillin and cefazolin,respectively.Conclusion After drug sensitivity testing,it was found that the incidence of resistance to commonly used antibiotics in the cultured strains was high,so clinicians should reasonably and standardly use antibiotics based on the drug sensitivity detection results of the identified strains to promote recovery,improve prognosis,and reduce the incidence of drug resistance.

关 键 词：皮肤肿瘤 药敏检测 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学] R739.5[医药卫生—临床医学]