急性细菌性皮肤感染病原菌耐药性及万古霉素治疗效果

Antimicrobial resistance of pathogenic bacteria in acute bacterial skin infection and therapeutic effect of vancomycin

目的研究急性细菌性皮肤感染的病原菌耐药性以及此患者实施万古霉素的治疗效果。方法选择108例急性细菌性皮肤感染患者进行数据研究采集患者皮损部位分泌物,培养病原菌,分析耐药性。每组54例,在观察组患者中,实施夫西地酸乳膏+万古霉素治疗,在对照组患者中,实施夫西地酸乳膏治疗。结果分离出病原菌143株,革兰阴性菌、革兰阳性菌依次是41株、102株,主要是杆菌、葡萄球菌属。对于红霉素、青霉素、四环素以及克林霉素,革兰阳性菌的耐药性高,敏感万古霉素以及利奈哩胺。对于氨节西林、阿莫西林、头孢曲松、氨曲南、头抱哩林、环丙沙星,革兰阴性菌的耐药性高,敏感亚胺培南。在治疗后,对比对照组患者,观察组患者的CD3+、CD4+、CD4+/CD8+均显著更高,CD8+、hsCRP、PCT、IL-6、EASI均明显更低(P<0.05)。结论急性细菌性皮肤感染患者的病原菌种类较丰富,耐药性不同。

Objective To investigate the resistance of pathogens in acute bacterial skin infections and the efficacy of vancomycin in this patient.Methods A total of 108 patients with acute bacterial skin infection were selected lor data study,the secretions of the lesions were collected,and then the pathogenic bacteria were cultured to analyze the drug resistance,and after grouping,54 cases in each group were treated with fusidic acid cream+vancomycin in the observation group,and fusidic acid cream treatment was implemented in the control group patients.Compare between-group data.Results 143 strains of pathogenic bacteria were isolated,41 strains and 102 strains of gram-negative bacteria and gram-positive bacteria,mainly bacillus and staphylococcus.Resistance to gram-positive bacteria is high for erythromycin,penicillin,tetracycline,and clindamycin,sensitive vancomycin,and linezolid.For ampicillin,amoxicillin,ceftriaxone,azlreonam,cefazolin,ciprofloxacin,gram-negative bacteria have high drug resistance and sensitivity imipenem.After treatment,CD3+,CD4+,CD4+/CD8+in the observation group were significantly higher,and CD8+,hsCRP,PCT,IL-6 and EAST were significantly lower(P<0.05).Conclusion Patients with acute bacterial skin infection have a wide variety of pathogenic bacteria and different drug resistance.