目的了解患者皮肤软组织感染的病原菌分布及其对抗菌药物的耐药性,为临床合理使用抗菌药物提供科学依据。方法对2010年6月-2013年6月皮肤软组织感染患者创面脓液或分泌物送检的727份标本进行细菌培养和病原菌鉴定,回顾性分析主要病原菌的药敏试验结果,采用WHONET5.6软件进行分析。结果 727份标本检出350株病原菌,检出率为48.1%;革兰阳性球菌238株占68.0%,革兰阴性杆菌105株占30.0%,真菌7株占2.0%;金黄色葡萄球菌对青霉素、红霉素和环丙沙星的耐药率分别为93.5%、64.9%和57.8%,铜绿假单胞菌对头孢哌酮、哌拉西林、亚胺培南、美罗培南和阿米卡星对常用抗菌药物的耐药率均≤6.1%,MRSA对氨苄西林、利福平、环丙沙星、头孢唑林的耐药率均显著高于MSSA(P〈0.05);MRCNS对青霉素、氨苄西林、环丙沙星、左氧氟沙星的耐药率均显著高于MSCNS(P〈0.05)。结论导致皮肤软组织感染的病原菌仍以革兰阳性球菌尤其是金黄色葡萄球菌为主,临床上抗感染治疗应根据药敏试验结果合理用药。
OBJECTIVE To investigate the distribution and drug resistance of pathogens of skin and soft tissue infections in order to provide the scientific evidence for clinical reasonable use of antibiotics.METHODS Totally 727 specimens of pus or wound secretion of patients with skin and soft tissue infections during the period of Jun.2010 to Jun.2013 in our hospital were collected for bacterial culture and pathogen identification.The results of drug sensitive test were retrospectively analyzed using the WHONET 5.6software.RESULTS A total of 350 strains were isolated from the 727 specimens with the detection rate of 48.1%.There were 238gram-positive strains(68.0%),105gram-negative strains(30.0%),and 7fungal strains(2.0%).The resistant rates of Staphylococcus aureus to penicillin,erythromycin,and ciprofloxacin were 93.5%,64.9%,and 57.8%.The resistant rates of Pseudomonas aeruginosa to common antibiotics such as cefoperazone,piperacillin,imipenem,meropenem and amikacin were all≤ 6.1%.Compared with MSSA,the resistant rates of MRSA to ampicillin,rifampicin,ciprofloxacin and cefazolin were all significantly higher(P〈0.05).Compared with MSCNS,the resistant rates of MRCNS to penicillin,ampicillin,ciprofloxacin and levofloxacin were all significantly higher(P〈0.05).CONCLUSION The pathogenic bacteria of skin and soft tissue infection are mainly gram-positive bacteria,especially S.aureus.The antimicrobial agents should be chosen according to the drug sensitivity test for the clinical antiinfection therapy.