皮炎湿疹患者皮肤菌群的测定及其临床意义分析

Detection of bacterial flora in skin of patients with eczematous dermatitis and its clinical significance

目的通过检测皮炎湿疹患者的皮肤菌群,并与正常皮肤寄生菌进行比较,探讨病原菌感染种类与皮炎湿疹类疾病的相关性,为临床治疗提供依据。方法在皮炎湿疹患者(皮损组)皮损部位和对应的非皮损(非皮损组)与健康对照组部位同时取材做细菌、真菌培养,培养结果进行常规菌种鉴定并进行相关统计分析。结果 90例皮炎湿疹患者皮损细菌总检出率为67.78%,金黄色葡萄球菌检出率为31.11%,马拉色菌检出率为47.78%,均明显高于非皮损部位及健康人正常皮肤,但三者表皮葡萄球菌检出率差异无统计学意义,并且金黄色葡萄球菌感染皮损中马拉色菌的检出率为71.43%,明显高于非金黄色葡萄球菌感染皮损部位的检出率37.1%;急性渗出型皮损细菌总检出率81.63%,显著高于慢性斑块型皮损的总检出率的51.22%,而二者金黄色葡萄球菌及马拉色菌检出率差异均无统计学意义;继发感染患者皮损金黄色葡萄球菌检出率37.78%,显著高于临床无感染的皮炎湿疹患者的检出率19.44%,而马拉色菌检出率差异均无统计学意义。结论皮损部位病原菌的感染或定植与皮炎湿疹类疾病的发生、发展和严重程度密切相关;当皮损部位金黄色葡萄球菌及马拉色菌感染增加时,炎症反应明显加重,且常表现为急性渗出型皮损;合理应用抗菌药物控制病原菌感染的种类和数量,有效地改善此类疾病的临床症状。

OBJECTIVE To investigate colonization of microbial population in the lesion of the patients with eczematous dermatitis,to evaluate the relation between microorganism infection and eczematous dermatitis,and to provide the basis of the rational use of antimicrobial agents.METHODS The bacterial and fungal samples were obtained from the lesion and non-lesion patients,the culture result was statistically analyzed for the routine bacterial identification.RESULTS The total detection rate of the bacteria from the lesions in 90 eczematous dermatitis patients was 67.78%,the isolation rate of Staphylococcus aureus was 31.11%,Malassezia 47.78%,both were significantly higher than that of the non-lesions patients and the healthy population,there was no significant difference in the detection rate of S.epedermidis between the threes groups,the detection rate of Malassezia from the patients with S.aureus infection lesions was 71.43%,significantly higher than 37.1% of the patients with non-S.aureus infection lesions.The total detection rate of the bacteria from the patients with acute exudative type of lesions was 81.63%,significantly higher than 51.22% of the patients with chronic exudative type of lesions,the difference in the detection rate of the S.aureus and Malassezia between the two groups was not statistically significant.The detection rate of S.aureus from the lesions of the patients with secondary infections was 37.78%,significantly higher than 19.44 of the eczematous dermatitis patients without secondary infections,the difference in the detection rate of Malassezia between the two groups was not statistically significant.CONCLUSION The bacterial infections or colonization in the lesion site is closely related to the incidence,development and severity of the eczematous dermatitis.The inflammation response aggravates as the lesion site with S.aureus infection and Malassezia infection increase,frequently presenting as acute exudative type of lesions.The reasonable use of antibiotics to control the pathogens causing infections can effectively improve the clinical symptom of the disease.