特应性皮炎患者皮损部位的金黄色葡萄球菌定植情况及药敏分析

Staphylococcus Atreus Colonization in the Skin Lesions of Patients with Atopic Dermatitis and its Drug Sensitivity Analysis

目的:了解特应性皮炎患者皮损部位的金黄色葡萄球菌定植情况及其药敏性,为该疾病的抗感染治疗提供研究依据。方法:136例特应性皮炎患者作为观察组,93名体检健康者作为对照组。检测并比较观察组皮损部位、观察组非皮损部位和对照组的病原菌分布情况,检测皮损部位检出金黄色葡萄球菌的药敏性,并观察湿疹面积及严重度指数(EASI)评分与菌落密度的相关性。结果:观察组皮损部位的病原菌阳性率为75.74%,均高于观察组非皮损部位和对照组的病原菌阳性率(P<0.01);观察组非皮损部位的病原菌阳性率高于对照组(P<0.01)。检出率最高的病原菌为革兰阳性菌;观察组中检出率最高的是金黄色葡萄球菌。EASI评分与菌落密度之间呈正相关(r=0.631,P<0.05)。观察组皮损部位检出的85株金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌(MRSA)检出率30.59%;甲氧西林敏感金黄色葡萄球菌(MSSA)和MRSA对左氧氟沙星、万古霉素、替加环素的敏感率均为100.00%;MSSA对头孢哌酮、头孢唑林、头孢西丁、利福平、阿奇霉素、克林霉素、磺胺甲噁唑/甲氧苄啶的敏感率均显著高于MRSA(P<0.05或P<0.01)。结论:特应性皮炎患者皮损部位普遍存在金黄色葡萄球菌定植,应根据药敏试验结果合理使用抗菌药。

Objective：To study the Staphylococcus aureus colonization in the skin lesions of patients with atopic dermatitis and its drug sensitivity, and to provide research basis for the anti infection treatment of the disease. Methods： 136 patients with atopic dermatitis were selected as observation group and 93 physical health persons as control group. The pathogenic bacteria distributions of skin lesions of observation group, non lesion site of observation group and control group were detected, the drug sensitivity of Staphylococcus aureus was detected in skin lesions, and the correlation between EASI score and colony density was observed. Results： The positive rate of pathogenic bacteria in skin lesions of observation group was 75.74%, which was higher than that in non lesion site of observation group and control group （ P 〈 0.01 ） ; the positive rate of pathogenic bacteria in non lesion site of observation group was higher than that in control group （ P 〈 0.01 ）. The highest detection rate of pathogenic bacteria was gram positive bacteria, and the detection rates of Staphylococcus aureus were highest in the lesions in skin lesions and non lesion site of observation group. EASI score was positively correlated with colony density （r = 0.631, P 〈 0.05 ）. In the 85 strains of Staphylococcus aureus detected in skin lesions of observation group, the detection rate of MRSA was 30.59% ; the susceptibility rates of MSSA and MRSA to levofloxacin, vancomycin and teieoplanin were 100.00% ; the sensitivity rates of MSSA to cefotaxime, cefazolin, cefoxitin, rifampin, azithromycin, clindamycin, sulfamethoxazole / trimethoprim were significantly higher than those of MRSA （ P 〈 0.05 or P 〈 0.01 ）. Conclusion： Staphylococcus aureus colonization in the skin lesions of patients with atopic dermatitis was common, and antibiotics should be used reasonably according to the results of drug sensitivity.