银屑病患者并发皮肤细菌感染的病原菌及耐药性分析

Analysis of pathogenic bacteria and drug resistance of psoriasis patients complicated with skin bacterial infections

目的了解银屑病患者并发皮肤细菌感染的病原菌及耐药性。方法收集2021年6月-2023年6月204例银屑病并发皮肤细菌感染患者,对其皮损处分泌物送检的204份标本进行细菌培养、病原菌鉴定,以及对主要病原菌进行药物敏感性试验。结果204例银屑病并发皮肤细菌感染患者共分离鉴定出病原菌292株,革兰阳性菌275株(占94.18%)、革兰阴性菌17株(占5.82%),其中金黄色葡萄球菌241株(占82.53%)。金黄色葡萄球菌对常用抗菌药物的耐药率由高到低依次为:青霉素98.34%、红霉素76.76%、林可霉素74.69%、复方新诺明42.74%、苯唑西林35.27%、四环素30.29%、庆大霉素4.56%、环丙沙星2.90%、利福平1.66%、左氧氟沙星1.66%、莫西沙星1.66%。金黄色葡萄球菌对替加环素、万古霉素、利奈唑胺、呋喃妥因、奎奴普丁/达福普汀未呈现出耐药性。241株金黄色葡萄球菌中耐甲氧西林的金黄色葡萄球菌(MRSA)检出率8.71%(21/241)、甲氧西林敏感的金黄色葡萄球菌(MSSA)检出率91.29%(220/241)。MRSA对苯唑西林、红霉素、林可霉素的耐药率高于MSSA(P<0.05)。结论银屑病患者并发皮肤细菌感染的病原菌种类较多,但以革兰阳性菌特别是金黄色葡萄球菌为主,金黄色葡萄球菌对青霉素、红霉素、林可霉素、复方新诺明、苯唑西林、四环素等多种常见抗菌药物的耐药率较高,且存在一定比例的MRSA感染。

Objective To understand the pathogenic bacteria and drug resistance of psoriasis patients complicated with skin bacterial infections.Methods From June 2021 to June 2023,204 patients with psoriasis complicated by skin bacterial infection were collected,and 204 samples of their skin lesions were collected for bacterial culture and pathogen identification,and drug sensitivity tests were conducted on the main pathogenic bacteria.Results A total of 292 strains of pathogenic bacteria were isolated and identified from 204 patients with psoriasis complicated by skin bacterial infection,including 275 strains of G+bacteria(94.18%),and 17 strains of G-bacteria(5.82%),and 241 strains were Staphylococcus aureus(82.53%).The resistance rate of S.aureus to commonly used antibiotics,from high to low,was as follows:penicillin(98.34%),erythromycin(76.76%),lincomycin(74.69%),compound sulfamethoxazole(42.74%),oxacillin(35.27%),tetracycline(30.29%),gentamicin(4.56%),ciprofloxacin(2.90%),rifampicin(1.66%),levofloxacin(1.66%),and moxifloxacin(1.66%).S.aureus did not show resistance to tigecycline,vancomycin,linezolid,furantoin,and quinuputin/dapfoptin.The detection rates of methicillin-resistant S.aureus(MRSA)and methicillin-sensitive S.aureus(MSSA)among 241 strains of S.aureus were 8.71%(21/241)and 91.29%(220/241),respectively.The resistance rate of MRSA to oxacillin,erythromycin,and lincomycin was higher than that of MSSA(P<0.05).Conclusion There are many types of pathogenic bacteria in psoriasis patients with skin bacterial infections,but G+bacteria,especially S.aureus,are the main pathogenic bacteria.S.aureus has a high resistance rate to various common antibiotics such as penicillin,erythromycin,lincomycin,compound sulfamethoxazole,oxacillin,tetracycline,and there is a certain proportion of MRSA infection.