青春期寻常性痤疮患者皮损分离菌株及其对常用抗菌药物的耐药性

Drug resistance of bacteria isolated from skin lesions in adolescent patients with acne vulgaris to commonly used antibacterial drugs

  • 摘要:
    目的 探讨青春期寻常性痤疮患者皮损分离菌类型, 分析其对常用抗菌药物的耐药情况。
    方法 选取2022年3月-2024年3月中国人民解放军总医院第七医学中心80例青春期寻常性痤疮患者, 采集其面部痤疮皮损内容物, 进行细菌鉴定, 采用E-test法评价分离菌对常用抗菌药物的耐药率。
    结果 本研究采集的皮损内容物样本痤疮丙酸杆菌检出74株(92.50%)、表皮葡萄球菌76株(95.00%)、金黄色葡萄球菌12株(15.00%);不同性别、年龄、病程、病情程度患者痤疮丙酸杆菌、表皮葡萄球菌、金黄色葡萄球菌检出率差异无统计学意义;痤疮丙酸杆菌对四环素、多西环素、米诺环素具有较高的敏感性(均>95%), 而对甲硝唑几乎完全耐药, 对红霉素、克拉霉素、克林霉素、罗红霉素、阿奇霉素等大环内酯类敏感率较低(<50%);表皮葡萄球菌对四环素、多西环素、米诺环素敏感率分别为67.11%、81.58%、82.89%, 对甲硝唑具有较高的耐药性(96.05%), 对红霉素、克拉霉素、克林霉素、罗红霉素、阿奇霉素敏感率较低(<60%);金黄色葡萄球菌对四环素、多西环素、米诺环素敏感性分别为58.33%、75.00%、75.00%, 而对红霉素、克拉霉素、克林霉素、罗红霉素、阿奇霉素敏感率分别为33.33%、41.67%、50.00%、41.67%、33.33%。
    结论 青春期寻常性痤疮患者皮损分离的细菌以表皮葡萄球菌、痤疮丙酸杆菌为主, 金黄色葡萄球菌检出率较低, 3种分离菌均对四环素类抗菌药物的敏感性较高, 而对大环内酯类抗菌药物耐药性较高, 且对甲硝唑几乎完全耐药。

     

    Abstract:
    OBJECTIVE To investigate the types of bacteria isolated from skin lesions in adolescent patients with acne vulgaris and analyze their drug resistance to commonly used antibacterial drugs.
    METHODS A total of 80 adolescent patients with acne vulgaris admitted to the Seventh Medical Center of Chinese PLA General Hospital from Mar. 2022 to Mar. 2024 were enrolled. The contents of facial acne skin lesions were collected for bacterial identification and the E-test method was employed to evaluate the drug resistance rates of isolated bacteria to commonly used antibacterial drugs.
    RESULTS Among the collected skin lesion samples in this study, 74 strains (92.50%) of Propionibacterium acnes, 76 strains (95.00%) of Staphylococcus epidermidis and 12 strains (15.00%) of S. aureus were detected. No statistically significant differences were observed in the detection rates of P. acnes, S. epidermidis and S. aureus among patients of different genders, ages, disease courses or severity levels. P. acnes exhibited high sensitivity to tetracycline, doxycycline and minocycline (all > 95%) but was almost completely resistant to metronidazole. Its sensitivity rate to macrolides such as erythromycin, clarithromycin, clindamycin, roxithromycin and azithromycin were low (< 50%). S. epidermidis showed sensitivity rates of 67.11%, 81.58% and 82.89% to tetracycline, doxycycline and minocycline, respectively, with high drug resistance to metronidazole (96.05%) and low sensitivity rate to erythromycin, clarithromycin, clindamycin, roxithromycin and azithromycin (< 60%). S. aureus demonstrated sensitivity rates of 58.33%, 75.00% and 75.00% to tetracycline, doxycycline and minocycline, respectively, while its sensitivity rates to erythromycin, clarithromycin, clindamycin, roxithromycin and azithromycin were 33.33%, 41.67%, 50.00%, 41.67% and 33.33%, respectively.
    CONCLUSIONS The predominant bacteria isolated from skin lesions in adolescent patients with acne vulgaris are S. epidermidis and P. acnes, with a lower detection rate of S. aureus. All three isolated bacteria exhibit high sensitivity to tetracycline antibacterial drugs but significant drug resistance to macrolides and near-complete drug resistance to metronidazole.

     

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