溶葡萄球菌酶对创面肉芽组织抗菌效果的临床研究

Antibiotic effect of lysostaphin on granulation wound

目的研究溶葡萄球菌酶在体外和创面肉芽组织中对金黄色葡萄球菌等几种有代表性的常见创面感染菌的抗菌效果。方法用体外药敏试验观察了溶葡萄球菌酶对金黄色葡萄球菌、白色念珠菌和铜绿假单孢菌抗菌效果；并用组织细菌定量分析的方法分析了溶葡萄球菌酶对29例Ⅲ度面积10％～30％总体表面积（total body Surface area，TBSA）的烧伤患者残留创面肉芽组织中金黄色葡萄球菌的抗菌效果。结果溶葡萄球菌酶对金黄色葡萄球菌有很强的抗菌效果，对白色念珠菌也有明显的抗菌效果；对铜绿假单孢菌的抗菌效果较差。溶葡萄球菌酶纱布在烧伤残留创面连续使用3d后，能杀死肉芽组织中89．2％的细菌。证明溶葡萄球菌酶能有效控制肉芽组织中的细菌数量。同时，杀菌纱布所含成分是生物酶类，使用后未见全身不良反应。结论溶葡萄球菌酶除了对金黄色葡萄球菌有很强的杀菌作用外，对白色念珠菌也有很好的杀菌作用，溶葡萄球菌酶可以作为控制中晚期烧伤残余创面金黄色葡萄球菌感染非常有效的局部用药。

Objective To investigate the effect of lysostaphin on golden staphylococcal bacteria in vitro and on acestoma tissue. Methods Effects of lysostaphin on golden staphylococcal bacteria, Candida albicans and P. aeruginosa were detected by drug sensitivity test. Quantitative analysis of bacteria was used to detect the effect of lysostaphin on golden staphylococcal bacteria in 29 cases of 10% - 30% TBSA. Results Most golden staphylococcal bacteria, as well as Candida albicans could be killed by lysostaphin. Lysostaphin had little effect on P. aeruginosa. Eighty-nine percent bacteria could be killed by lysostaphin after gauze with lysostaphin had been used for over 3 d, indicating lysostaphin may control bacteria quantity and improve survival rate of skin graft on granulation tissue. Gauze with lysostaphin contained biological enzymes and it had no systemic side effects. Conclusion Gauze with lysostaphin may be available on controlling golden staphylococcal bacteria as well as Candida albicans in burnt patients. Lysostaphin is effective in controlling residual trauma infected by golden staphylococcal bacteria.