皮肤恶性肿瘤皮损病原体感染分析

Infections of Pathogens in Lesions of Cutaneous Carcinoma

目的调查皮肤恶性肿瘤住院患者皮损特点及其合并病原体感染情况,为临床医生提供合理用药依据。方法利用VITEK 2 Compact全自动细菌鉴定及药敏分析系统对88例皮肤恶性肿瘤住院患者中有破溃的皮损分泌物标本进行病原体鉴定及药敏分析。结果阳性结果为31例,其中革兰阳性菌18株,以金黄色葡萄球菌为主,革兰阴性菌13株,以铜绿假单胞菌和奇异变形杆菌为主。革兰阳性菌对大环内酯类抗生素耐药率为72.2%。革兰阴性菌对多西环素耐药率达到了100%,对头孢类抗生素也高度耐药。此外共发现了4例多重耐药菌株。结论皮肤恶性肿瘤有破溃的皮损合并细菌感染很普遍,应根据菌种鉴定及药敏结果给予相应的术前术后处理。

Objective To investigate the lesions and pathogen infections of the inpatients diagnosed as cutaneous carcinoma, and provide the basis of rational drug use for clinicians. Methods For the 88 inpatients with cutaneous carcinoma, secretions were collected from the 41 patients whose lesions were ulcerative. VITEK 2 Compact automatic bacterial identification and susceptibility analysis system were applied to perform species identification and drug resistance testing. Results Thirty-one were positive for the culture of pathogens, among which 18 were Gram-positive bacterium and staphylococcus aureus was the majority;13 were Gram-negative bacterium and pseudomonas aeruginosa and proteus mirabilis were the majority. The resistant rate of Gram-positive bacterium to macrolide antibiotics was 72.5%. The resistant rate of Gram-negative bacterium to doxycycline reached 100%, and it was also highly resistant to cephalosporin antibiotics. Additionally, four cases of multi-drug resistant bacteria were found. Conclusion Since bacterial infections are prevalent in the ulcerative lesions of cutaneous carcinoma, clinician should perform pre- and post-operative interventions on the basis of strains identification and susceptibility test results.