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重症寻常型天疱疮严重皮肤感染的病原学分析及抗菌药物治疗
Etiological analysis of severe pemphigus vulgaris patients with severe skin infections and antibiotic therapy
【摘要】 目的探讨重症寻常型天疱疮合并严重皮肤感染病原菌和耐药性,找出敏感抗生素并及时联合激素应用,以提高临床治疗水平。方法随机选取2011年1月至2013年3月61例重症寻常型天疱疮患者为研究对象,对其中伴有严重皮肤感染39的患者进行病原菌和耐药性分析。结果对病原菌分布进行比较,共分离出病原菌52株,其中革兰阴性菌占全部病原菌48.08%,革兰阳性菌占全部病原菌30.77%,真菌占21.15%。在革兰阴性菌中耐药性较低的抗菌药物有利福平、亚胺培南,均为0,而在革兰阳性菌中耐药性较低的抗生素为替考拉宁、万古霉素,均为0,真菌中耐药性较低的抗生素为5-氟胞嘧啶、两性霉素B,均为0。经一系列对症治疗后总有效率为66.67%,死亡率20.51%。结论重症寻常型天疱疮合并严重皮肤感染病原菌较为均匀,选择敏感抗生素可提高临床效果。
【Abstract】 Objective To investigate severe pemphigus vulgaris patients with severe skin infections and drug-resistant pathogens,antibiotics and promptly identify the combined hormone sensitive applications to improve the level of clinical treatment. Methods Randomly selected from January 2011 to March 2013 61 cases of severe pemphigus vulgaris patients for the study,of which 39 with severe skin infections in patients with drug-resistant pathogens and analysis. Results The distribution of the pathogen compare 52 were isolated pathogens,including gram-negative bacteria accounted for 48. 08% of all bacteria,Gram-positive bacteria accounted for 30. 77% of all bacteria,fungi accounted for 21. 15%. In Gram-negative bacteria resistant to antimicrobial drugs less rifampicin,imipenem,are 0,while in Gram-positive bacteria resistant to antibiotics lower teicoplanin,vancomycin,are 0,a low resistance to fungal antibiotic is 5-fluorocytosine,amphotericin B,0. After a series of symptomatic total effective rate was 66. 67%,20. 51% mortality rate. Conclusion Severe pemphigus vulgaris patients with severe skin infection pathogens more uniform,select sensitive antibiotics can improve clinical results.
【Key words】 Severe pemphigus vulgaris; Severe skin infections; Etiology; Drug resistance;
- 【文献出处】 医药论坛杂志 ,Journal of Medical Forum , 编辑部邮箱 ,2014年07期
- 【分类号】R758.6
- 【被引频次】7
- 【下载频次】104