首页|某三甲专科医院住院患者皮损部位的多重耐药性分析及变化趋势

某三甲专科医院住院患者皮损部位的多重耐药性分析及变化趋势

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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3 331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(x2=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.
Analysis of multidrug resistance in skin lesion of inpatients and the trend of changes in a tertiary specialized hospital
Objective To reveal the prevailing scenarios of cutaneous infections and multi-drug resistance of skin lesions,and nosocomial infections among inpatients in dermatology hospi-tal.Methods Clinical data,including pathogens from skin lesions,were collected from inpa-tients at Dermatology Hospital of Southern Medical University between October 2019 and Septem-ber 2022.The analyses included multi-drug-resistant organism(MDRO),extensively drug-resist-ant organisms,and the annual variations and resistance profiles of the top five pathogens.Results Over the three years,3 331 pathogen strains were cultured from skin lesions,predominantly Gram-positive bacteria(77.72%),Gram-negative bacteria(17.35%)and fungi(4.92%).Ec-zematous 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 Staphy-lococcus aureus and Coagulase-negative staphylococci tended to be increased annually(P<0.05).However,multi-drug-resistant Staphylococcus aureus infections and methicillin-esistant Staphylo-coccus 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 de-clined annually(x2=26.26,P<0.05).Conclusions Gram-positive bacteria such as staphylo-cocci 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.

multidrug resistanceStaphylococcusgram-positive bacteriaspecialized hospitalnosocomial infection

田彧旸、邱慧、刘娇

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南方医科大学皮肤病医院,广东 广州 510091

多重耐药 葡萄球菌 革兰阳性菌 专科医院 医院感染

2024

皮肤性病诊疗学杂志
广东省皮肤性病防治中心

皮肤性病诊疗学杂志

影响因子:0.666
ISSN:1674-8468
年,卷(期):2024.31(2)
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