葡萄球菌性烫伤样皮肤综合征表皮剥脱毒素分型及耐药分析

发布时间：2018-04-02 14:00

本文选题：金黄色葡萄球菌　切入点：葡萄球菌性烫伤样皮肤综合征　出处：《中国皮肤性病学杂志》2014年08期

【摘要】：目的探讨引起本地区46例葡萄球菌性烫伤样皮肤综合征(staphylococcal scalded skin syndrome,SSSS)患者的金黄色葡萄球菌(staphylococcus aureus,SA)所分泌的表皮剥脱毒素(exfoliative toxin,ET)血清型及SA的耐药情况,并与寻常型脓疱疮及皮肤疖肿组进行对比。方法 138株SA分离自SSSS(46株),寻常型脓疱疮(49株),皮肤疖肿组(43株)。应用多重PCR方法检测SA产生的ET类型,应用Kirby-Bauer纸片法检测SA对15种抗生素的耐药情况。结果 SSSS组SA共46株(100.00%)均产生ET,均是以单产ETB为主;寻常型脓疱疮组产生ETB的有30株(61.22%);皮肤疖肿组无一株产生ETB。138株SA均未检测到ETA或ETD的表达。三组SA分泌ET的比例差异存在统计学意义(P0.05)。SSSS、寻常型脓疱疮及皮肤疖肿组对青霉素、红霉素、克林霉素的耐药率较高,而对一、二代头孢类抗生素较敏感。三组共发现6株耐甲氧西林金黄色葡萄球菌(MRSA)。结论内蒙古呼和浩特市地区SSSS的致病SA主要以单产ETB为主。本地区SA主要对青霉素、红霉素、克林霉素高度耐药,对一、二代头孢类抗生素较敏感。
[Abstract]:Objective to investigate the serotype of staphylococcal scalded skin syndromes secreted by Staphylococcus aureus Staphylococcus aureus and the drug resistance of SA in 46 patients with staphylococcal scalded skin syndrome. Methods A total of 138 SA strains were isolated from SSSS(46 strain, 49 strains from pustule vulgaris group and 43 strains from furuncle group. The et type of SA was detected by multiple PCR method. The resistance of SA to 15 antibiotics was detected by Kirby-Bauer disk method. Results 46 strains of SA in SSSS group produced ETS, mainly ETB per unit yield. 30 strains of ETB were produced in the pustular vulgaris group, none of the SA strains produced ETB.138 strain in the furuncle group and none of the SA strains produced ETA or ETD expression. There was significant difference in the proportion of et secreted by SA in the three groups (P 0.05. SSSS), penicillin was detected in the patients with pustular vulgaris and furuncle of skin. Erythromycin, clindamycin resistance rate is higher, but to one, Six strains of methicillin-resistant Staphylococcus aureus were found in the three groups. Conclusion the main pathogenic SA of SSSS in Hohhot, Inner Mongolia, is ETB per unit production, which is mainly related to penicillin and erythromycin. Clindamycin is highly resistant to the first and second generation of cephalosporins.
【作者单位】：内蒙古鄂尔多斯市中心医院皮肤科;内蒙古医科大学附属医院皮肤科;
【分类号】：R753

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