中华皮肤科杂志 ›› 2004, Vol. 37 ›› Issue (10): 595-597.

• 论著 • 上一篇    下一篇

湿疹与特应性皮炎皮损处细菌学研究

毕志刚1, 田美华1, 林麟2, 仇宁2, 郝飞3, 钟白玉3, 尹若菲4, 曾凡钦4, 赵辨1   

  1. 1. 南京医科大学第一附属医院皮肤科 210029;
    2. 中国医学科学院、中国协和医科大学皮肤病研究所;
    3. 第三军医大学西南医院皮肤科;
    4. 中山大学第二医院皮肤科
  • 收稿日期:2004-04-05 出版日期:2004-10-15 发布日期:2004-10-15
  • 通讯作者: 赵辨,E-mail:zhobian@sina.com E-mail:zhobian@sina.com

Bacteriological Study on the Skin Lesions of Patients with Eczema and Atopic Dermatitis

BI Zhi-gang1, TIAN Mei-hua1, LIN Lin2, QIU Ning2, HAO Fei3, ZHONG Bai-yu3, YIN Ruo-fei4, ZENG Fan-qin4, ZHAO Bian1   

  1. Department of Dermatology and Venereology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
  • Received:2004-04-05 Online:2004-10-15 Published:2004-10-15

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摘要： 目的 探讨湿疹和特应性皮炎(AD)皮损处的细菌学特点及金黄色葡萄球菌(金葡菌)在湿疹及AD发病中的作用。方法 多中心随机双盲对207例湿疹患者和119例AD患者皮损及非皮损处取材做细菌培养,并对所分离到的金葡菌进行常规药敏试验和噬菌体分型。结果 207例湿疹患者皮损处的细菌检出阳性率、金葡菌的比例及定植均明显高于非皮损处,差异有显著性(P<0.01)。119例AD患者皮损处的细菌检出阳性率及金葡菌的定植明显高于非皮损处,差异有显著性。对分离到的141株金葡菌进行噬菌体分型。Ⅰ组占6.3%,Ⅱ组占7.0%,Ⅲ组占3.5%,Ⅴ组占0.7%,杂组占1.4%,不能分型占56%,MRSA分型噬菌体26株混合组占6.3%。药敏试验结果表明在常用的6种外用抗菌药物中莫匹罗星对金葡菌和表皮葡萄球菌的抗菌活性最强,其MIC范围、MIC90和MIC50是6种抗菌药物中最低的。且莫匹罗星对金葡菌及其中的各噬菌体分型和表皮葡萄球菌中的耐甲氧西林和耐甲氧西林凝固酶阴性菌株也有较好的抑菌能力。结论 湿疹和AD的发病与细菌感染密切相关,其中金葡菌是最重要的细菌,对湿疹和AD患者外用药治疗合并使用外用抗菌药物是必要的,根据对金葡菌抗菌活性的测定,莫匹罗星的效果较好。

关键词: 湿疹, 皮类, 特应性, 葡萄球菌, 金黄色, 微生物敏感试验

Abstract: Objective To study the bacteriological characteristics and the pathogenesis of Staphylococcus aureus (S. aureus) on eczema and atopic dermatitis (AD). Methods A multi-center randomized, double blind bacteriological study on the lesions and non-lesional skin of patients with eczema (207) and AD (119) were carried out. The antibiotic sensitivity and the bacteriophage typing were performed on all the S. aureus isolated from the patients. Results There were statistical differences in the positive rate of the culture, the ratio and the colonization of S. aureus between the lesion and the non-lesional skin in eczema (P<0.01). The positive rate of culture and the colonization of S. aureus in the lesions was significantly higher than those in the non-lesional skin (P<0.01) in 119 AD patients. The results of bacteriophage typing of 141 strains of S. aureus isolated were as follows:type I, II, III, V and miscellaneous type accounted for 6.3%, 7.0%, 3.5%, 0.7% and 1.4% respectively, 56% of the strains were unable to be typed. In 26 strains of MRSA, 9 strains (6.3%) were of mixture type. The results of antibiotic sensitivity tests indicated that the MIC, MIC50 and MIC90 of mupirocin for S. aureus were the lowest among those of other 5 topical antibiotics. Mupirocin was also sensitive to all different phage types of S. aureus, even to MRSA and MRCNS strains. Conclusions The bacteria (especially S. aureus) infection are important in the pathogenesis of eczema and AD, the combination of topical corticosteroid and antibiotics may be beneficial in the treatment of eczema and AD.

Key words: Eczema, Dermatitis, atopic, Staphylococcus aureus, Microbial sensitivity tests