摘要
目的了解三甲专科医院皮肤病住院患者皮损感染的一般情况、多重耐药及医院感染情况。方法收集整理2019年10月—2022年9月南方医科大学皮肤病医院住院患者皮损部位培养检出菌株的临床数据,分析多重耐药菌(MDRO)、主要特殊耐药菌、检出数居前5位的病原菌的年度变化、耐药情况等。结果三年间的皮损标本培养共检出3331株病原菌,其中革兰阳性菌占77.72%,革兰阴性菌占17.35%,真菌占4.92%。皮损培养阳性患者中占比最高的疾病类型为湿疹性皮肤病(27.32%)。检出菌株数前5的病原菌为金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌、白色念珠菌和肺炎克雷伯菌,其中金黄色葡萄球菌和表皮葡萄球菌的构成比呈逐年增长趋势(均P<0.05)。3年间金黄色葡萄球菌多重耐药检出率、耐甲氧西林金黄色葡萄球菌(MRSA)的检出率呈下降趋势(P<0.05)。MDRO总检出率为45.39%,医院感染总发生率为0.67%,MDRO医院感染发生率呈逐年下降趋势(χ^(2)=26.26,P<0.05)。结论葡萄球菌等革兰阳性菌是皮损感染中最常见的病原菌,经验性使用抗生素时应首先考虑抗菌谱覆盖上述菌的抗生素。三年间MDRO和MRSA的医院感染发生率逐年下降,皮肤病医院对MDRO及MRSA的管控有效。表皮葡萄球菌及其多重耐药的检出率逐年增长,应加强对表皮葡萄球菌感染的管理。
Objective To reveal the prevailing scenarios of cutaneous infections and multi-drug resistance of skin lesions,and nosocomial infections among inpatients in dermatology hospital.Methods Clinical data,including pathogens from skin lesions,were collected from inpatients at Dermatology Hospital of Southern Medical University between October 2019 and September 2022.The analyses included multi-drug-resistant organism(MDRO),extensively drug-resistant organisms,and the annual variations and resistance profiles of the top five pathogens.Results Over the three years,3331 pathogen strains were cultured from skin lesions,predominantly Gram-positive bacteria(77.72%),Gram-negative bacteria(17.35%)and fungi(4.92%).Eczematous dermatoses exhibited the highest incidence among positive cultures of skin lesions(27.32%).The top 5 pathogens were Staphylococcus aureus,Coagulase-negative staphylococci,Pseudomonas aeruginosa,Candida albicans and Klebsiella pneumoniae.The proportions of Staphylococcus aureus and Coagulase-negative staphylococci tended to be increased annually(P<0.05).However,multi-drug-resistant Staphylococcus aureus infections and methicillin-esistant Staphylococcus aureus(MRSA)tended to be decreased(P<0.05).The overall MDRO detection rate was 45.39%,with a hospital infection rate of 0.67%.The rate of MDRO in nosocomial infections declined annually(χ^(2)=26.26,P<0.05).Conclusions Gram-positive bacteria such as staphylococci are the common pathogens in cutaneous lesion infections,suggesting that the first choice of antibiotics should be those targeting these strains.Declines in MDRO and nosocomial infections of MRSA indicate effective control of infections in the dermatology hospital.However,the increasing prevalence and resistance in coagulase-negative staphylococci underscore the need for heightened management of these infections.
作者
田彧旸
邱慧
刘娇
TIAN Yuyang;QIU Hui;LIU Jiao(Dermatology Hospital,Southern Medical University,Guangzhou 510091,China)
出处
《皮肤性病诊疗学杂志》
2024年第2期88-94,共7页
Journal of Diagnosis and Therapy on Dermato-venereology
关键词
多重耐药
葡萄球菌
革兰阳性菌
专科医院
医院感染
multidrug resistance
Staphylococcus
gram-positive bacteria
specialized hospital
nosocomial infection
