CAJ | 학술논문

目的分析复杂皮肤软组织感染的病原菌及对抗生素的敏感性.方法回顾性分析99例复杂皮肤软组织感染住院患者的临床资料和病原学检验结果.结果复杂皮肤软组织感染共99例,共检出99株病原菌,其中革兰阳性菌51株,葡萄球菌是主要致病菌,该菌对红霉素、青霉素G、氯洁霉素、苯唑西林、左氧氟沙星有较高的耐药率,其中红霉素的耐药率达95.45％、青霉素G 72.73％;对替考拉宁、万古霉素、利拉唑胺、夫西地酸、莫西沙星敏感性较高；葡萄球菌中社区获得性感染对复方磺胺甲(噁)唑、四环素、环丙沙星的敏感性高于医院感染(P＜0.05)；发现耐甲氧西林金黄色葡萄球菌11株.革兰阴性菌48株,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌等为主要的致病菌；革兰阴性菌对左氧氟沙星、复方磺胺甲(噁)唑、庆大霉素有较高的耐药性,医院感染尤为突出；对碳青霉烯类、妥布霉素、哌拉西林、他唑巴坦敏感性较好.结论复杂皮肤软组织感染的病原菌种类繁多,耐药性较高,应在药物敏感试验指导下合理用药.
목적 분석복잡피부연조직감염적병원균급대항생소적민감성.방법 회고성분석99례복잡피부연조직감염주원환자적림상자료화병원학검험결과.결과 복잡피부연조직감염공99례,공검출99주병원균,기중혁란양성균51주,포도구균시주요치병균,해균대홍매소、청매소G、록길매소、분서서림、좌양불사성유교고적내약솔,기중홍매소적내약솔체95.45％、청매소G 72.73％;대체고랍저、만고매소、리랍서알、부서지산、막서사성민감성교고；포도구균중사구획득성감염대복방광알갑(오)서、사배소、배병사성적민감성고우의원감염(P＜0.05)；발현내갑양서림금황색포도구균11주.혁란음성균48주,동록가단포균、폐염극뢰백균、대장애희균、포만불동간균등위주요적치병균；혁란음성균대좌양불사성、복방광알갑(오)서、경대매소유교고적내약성,의원감염우위돌출；대탄청매희류、타포매소、고랍서림、타서파탄민감성교호.결론 복잡피부연조직감염적병원균충류번다,내약성교고,응재약물민감시험지도하합리용약.
Objective To identify the pathogens causing complicated skin and soft tissue infection and their susceptibility to antibiotics.Methods The clinical data on and aetiological examination findings in 99 cases of complicated skin and soft tissue infection were retrospectively analyzed.Results Totally,99 bacterial strains were isolated,including 51 Gram-positive bacteria (29 community-associated,22 hospital-acquired)and 48 Gram-negative bacteria ( 13 community-associated,35 hospital-acquired).Of the Gram-positive bacteria,staphylococci were the most common bacteria,which showed a high resistance rate to erythromycin (95.45％),penicillin G (72.73％),clindamycin,oxacillin and levofloxacin,but a high sensitivity to teicoplanin,vancomycin,linezolid,fusidic acid and moxifloxacin.Besides,the community-associated staphylococci possessed a higher sensitivity to trimethoprim + sulfamethoxazole,tetracycline and ciprofloxacin than the hospital-acquired staphylococci did (all P ＜ 0.05).Notably,11 of the 99 isolates were identified as methicillin-resistant staphylococcus aureus (MRSA).The four predominant Gram-negative bacteria were Pseudomonas aeruginosa,Klebsiella pneumonia,Escherichia coliand Acinetobacter baumannii.These Gram-negative bacteria,especially the hospital-acquired Gram-negative bacteria,exhibited high resistance to levofloxacin,trimethoprim + sulfamethox azole and gentamicin but favorable sensitivity to carbapenems,tobramycin,piperacillin and tazobactam.Conclusions Complicated skin and soft tissue infection is caused by various species of bacteria with high resistance to common antibiotics.Therefore,the results of drug sensitive tests should serve as the basis for proper use of antibiotics in the treatment of complicated skin and soft tissue infection.