天疱疮患者206例皮损分泌物病原学及药敏结果分析

Pathogens and Antimicrobial Resistance of Bacteria Pathogens in 206 Patients with Pemphigus

目的分析天疱疮患者糜烂面皮损的病原菌组成及药敏情况,为临床早期合理选用抗生素提供依据。方法对本科2004年1月-2011年12月收治的206例天疱疮患者皮损分泌物细菌培养和药敏结果进行回顾性分析。结果分离出细菌200株中,金黄色葡萄球菌107株,耐甲氧西林金黄色葡萄球菌11株;50%以上金黄色葡萄球菌对青霉素、红霉素、克林霉素耐药,100%对万古霉素敏感,80%以上对利福平、复方新诺明敏感;29例多部位取材共检出病原菌53株。结论天疱疮糜烂面细菌主要由金黄色葡萄球菌构成,多数对青霉素、红霉素及克林霉素耐药,对万古霉素、利福平和复方新诺明敏感;病程长且多次就诊者易感染耐甲氧西林金黄色葡萄球菌;抗生素早期使用可参考皮损主要累及部位及该部位常见定植菌种类选择。

Objective To provide the Scientific evidence for clinically reasonable use of antibiotics by analyzing patho- genic species and antimicrobial resistance in skin infection of patients with pemphigus. Methods The path- ogenic species from erosions and results of antibiotics resistance from January 2004 to December 2011 were retrospectively analysed. Results Two hundred strains were separated, which included 107 strains of S. aureus and 11 strains of Methicillin resistant S. aureus（MRSA） among the others. More than half of S. au- reus were drug resistant to Erythromycin, Clindamycin and Benzylpenicillin, but more than 80% were sensi- tive to Vancomycin, Rifampicin and Cotrimoxazole. 53 strains were isolated from 58 different sites in 29 pa- tients. Conclusion In patients with pemphigus, S. aureus is the main pathogen. Most of them are resistant to Erythromycin, Clindamycin and Benzylpenicillin, otherwise sensitive to Vaneomycin, Rifampicin and Cot- rimoxazole. The patients who have long duration of disease and get treatment several times are susceptible to develop MRSA. We can choose antibiotics depending on the results of drug resistance and the location of le-sions.