皮肤软组织感染人群病原菌分布与其耐药性分析

目的:研究某院皮肤科皮肤软组织感染(SSTI)人群中病原菌分布,并分析其耐药性。方法:选取2013年2月-2018年10月该院皮肤科SSTI患者创面分泌物或脓液942份标本,进行菌种鉴定及药敏试验。结果:942份标本中检出病原菌共456株,检出率为48.41%,其中革兰阳性球菌占69.30%,革兰阴性杆菌占28.07%,真菌占2.63%。金黄色葡萄球菌、表皮葡萄球菌及溶血葡萄球菌均对青霉素的耐药率最高,耐药率分别为94.51%、100%、100%;而对莫匹罗星、利奈唑胺、万古霉素及替拉考宁4种药物未呈现出耐药性。MRSA对氨苄西林、利福平、环丙沙星、头孢唑林的耐药率均显著高于MSSA(P<0.05),MRCNS对青霉素、氨苄西林、环丙沙星、左氧氟沙星的耐药率均显著高于MSCNS(P<0.05)。铜绿假单胞菌及肠杆菌科细菌均对氨苄西林和头孢唑林的耐药率最高,铜绿假单胞菌对二者的耐药率分别达到95.92%和97.96%;肠杆菌科细菌对二者的耐药率分别达到77.22%和54.43%。结论:革兰阳性球菌是引起SSTI的常见致病菌,其次是革兰阴性杆菌,革兰阳性球菌中的常见致病菌均对青霉素呈现高度耐药,革兰阴性杆菌中常见致病菌对氨苄西林和头孢唑林均呈现出较高的耐药性,临床应根据病原学检查结果,合理应用抗菌药物。

Distribution and drug resistance of pathogenic bacteria in dermatology skin and soft tissue infection population

OBJECTIVE To study the distribution of pathogens in skin soft tissue infection (SSTI) population in the Department of Dermatology and analyzed the drug resistance in a hospital.METHODS 942 specimens of wound secretion or pus. from patients with SSTI in the Department of Dermatology of the hospital from February 2013 to October 2018 were selected for bacterial identification and drug susceptibility testing.RESULTS A total of 456 pathogens were detected in 942 specimens with a detection rate of 48.41%, of which Gram-positive cocci accounted for 69.30%, Gram-negative bacilli accounted for 28.07%, and fungi accounted for 2.63%. Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus all had the highest resistance rate to penicillin, and the resistance rates were 94.51%, 100%, 100%, respectively; there were no drug resistance to 4 kinds of drugs such as mupirocin, linezolid, vancomycin and teicoplanin. The resistance rates of MRSA to ampicillin, rifampicin, ciprofloxacin, and cefazolin were significantly higher than those of MSSA (P<0.05), and the resistance rates of MRCNS to penicillin, ampicillin, ciprofloxacin, and levofloxacin were significantly higher than those of MSCNS (P<0.05).The resistance rates of Pseudomonas aeruginosa and Enterobacteriaceae to ampicillin and cefazolin were among the highest. The resistance rates of Pseudomonas aeruginosa and Enterobacteriaceae to ampicillin and cefazolin were 95.92% and 97.96% respectively. The resistance rates of Enterobacteriaceae to ampicillin and cefazolin were 77.22% and 54.43% respectively.CONCLUSION Gram-positive cocci are common pathogens causing SSTI, followed by Gram-negative bacilli, common pathogens in Gram-positive cocci are highly resistant to penicillin, and common pathogens in Gram-negative bacilli to ampicillin and cefazolin have high drug resistance, and antibacterial drugs should be rationally administered based on the results of pathogens.