湿疹伴细菌感染定植的检测和治疗

Detection of bacteriological colonization and treatment in the patients with eczema accompanied with infection

目的:分析湿疹皮损处的细菌定植情况并评价地奈德乳膏与夫西地酸乳膏联合外用治疗的疗效。方法:84例湿疹患者分两组:A组外用地奈德乳膏(2次/天)和夫西地酸乳膏(2次/天),B组外用地奈德乳膏(2次/天),分别于治疗后7天和14天观察疗效,治疗前皮损处取材做细菌培养和药敏。结果:治疗7天和14天后,A组患者的有效率为71.43%和88.09%明显高于B组的42.86%和69.05%(P=0.008和P=0.033)。84例湿疹患者中45例患者皮损处培养鉴定细菌阳性,包括金黄色葡萄球菌32株(38.09%),表皮葡萄球菌10株(11.9%),大肠埃希菌2株(2.38%),溶血性链球菌1株(1.19%)。结论:湿疹皮损易伴发微生物感染,地奈德联合夫西地酸外用治疗伴发细菌感染的湿疹可提高疗效。

Objective： To detection the bacteriological colonization of eczema and assess the efficacy of desonide cream combined with fusidic acid cream in the treatment of infected eczema. Methods： Eighty four patients with eczema were randomly divided into two groups. Patients in group A were treated with desonide cream（ twice a day） combined with fusidic acid cream（ twice a day）,and patients in group B were given desonide cream only（ twice a day） for 14 days. Effective rate was assessed after treatment of 7 days and 14 days. Bacterial cultures and drug sensitivity test were performed before treatment. Results： The effective rates after 7 days and 14 days treatment in group A were 71. 43% and 88. 09% respectively,which were significantly higher than those in group B（ 42. 86% and 69. 05%）. The differences were significant（ P = 0. 008 and P = 0. 033）. The bacteria culture of 45 patients was positive,including 32 isolated of staphylococcus aureus,10 staphylococcus epidermis,2 escherichia coli and 1 streptococcus. Conclusion： Eczema usually accompanied with bacterial infection and desonide cream combined with fusidic acid cream is effective in the treatment of infected eczema.