中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (11): 800-802.

• 论著 • 上一篇    下一篇

99例复杂皮肤软组织感染的病原学分析

陈丽红1,蔡仁慧1,施秀明2,程波3   

  1. 1. 福建医科大学附属第一医院
    2. 福建医科大学附属第一医院皮肤科
    3. 福州市福建医科大学附属第一医院皮肤科(联系人苏惠春)
  • 收稿日期:2010-10-28 修回日期:2011-08-08 出版日期:2011-11-15 发布日期:2011-11-01
  • 通讯作者: 程波 E-mail:chengbo630415@126.com

Aetiological analysis of 99 patients with complicated skin and soft tissue infection

  • Received:2010-10-28 Revised:2011-08-08 Online:2011-11-15 Published:2011-11-01

摘要:

目的 分析复杂皮肤软组织感染的病原菌及对抗生素的敏感性。方法 回顾性分析99例复杂皮肤软组织感染住院患者的临床资料和病原学检验结果。结果 复杂皮肤软组织感染共99例,共检出99株病原菌,其中革兰阳性菌51株,葡萄球菌是主要致病菌,该菌对红霉素、青霉素G、氯洁霉素、苯唑西林、左氧氟沙星有较高的耐药率,其中红霉素的耐药率达95.45%、青霉素G 72.73%;对替考拉宁、万古霉素、利拉唑胺、夫西地酸、莫西沙星敏感性较高;葡萄球菌中社区获得性感染对复方磺胺甲噁唑、四环素、环丙沙星的敏感性高于医院感染(P < 0.05);发现耐甲氧西林金黄色葡萄球菌11株。革兰阴性菌48株,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌等为主要的致病菌;革兰阴性菌对左氧氟沙星、复方磺胺甲噁唑、庆大霉素有较高的耐药性,医院感染尤为突出;对碳青霉烯类、妥布霉素、哌拉西林、他唑巴坦敏感性较好。结论 复杂皮肤软组织感染的病原菌种类繁多,耐药性较高,应在药物敏感试验指导下合理用药。

关键词: 敏感试验

Abstract:

Objective To identify the pathogens causing complicated skin and soft tissue infection and their susceptibility to antibiotics. Methods The clinical data on and aetiological examination findings in 99 cases of complicated skin and soft tissue infection were retrospectively analyzed. Results Totally, 99 bacterial strains were isolated, including 51 Gram-positive bacteria (29 community-associated, 22 hospital-acquired) and 48 Gram-negative bacteria (13 community-associated, 35 hospital-acquired). Of the Gram-positive bacteria, staphylococci were the most common bacteria, which showed a high resistance rate to erythromycin (95.45%), penicillin G (72.73%), clindamycin, oxacillin and levofloxacin, but a high sensitivity to teicoplanin, vancomycin, linezolid, fusidic acid and moxifloxacin. Besides, the community-associated staphylococci possessed a higher sensitivity to trimethoprim + sulfamethoxazole, tetracycline and ciprofloxacin than the hospital-acquired staphylococci did (all P < 0.05). Notably, 11 of the 99 isolates were identified as methicillin-resistant staphylococcus aureus (MRSA). The four predominant Gram-negative bacteria were Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli and Acinetobacter baumannii. These Gram-negative bacteria, especially the hospital-acquired Gram-negative bacteria, exhibited high resistance to levofloxacin, trimethoprim + sulfametho-xazole and gentamicin but favorable sensitivity to carbapenems, tobramycin, piperacillin and tazobactam. Conclusions Complicated skin and soft tissue infection is caused by various species of bacteria with high resistance to common antibiotics. Therefore, the results of drug sensitive tests should serve as the basis for proper use of antibiotics in the treatment of complicated skin and soft tissue infection.

Key words: drug sensitive test