Webb D, Thadepalli H
West J Med. 1979 Mar;130(3):200-4.
Skin and soft tissue infections were studied in 21 seriously ill narcotic addicts who had been admitted to hospital. Subcutaneous abscesses were present in 14 patients; cellulitis was noted in 3, pyomyositis in 2 and necrotizing fasciitis in 2. In four patients there was septicemia. Infections in 14 patients (66.6 percent) were associated with anaerobic bacteria, which were the exclusive isolates in 6 patients. In seven patients (33.3 percent) isolates were exclusively aerobic bacteria and in eight both aerobes and anaerobes were present. The anaerobic isolates were clostridia (six), peptostreptococci (five), bacteroides (five), peptococci (three), and one of each of Veillonella, Propionibacterium, Eubacterium, Fusobacterium and Actinomyces. Staphylococcus aureus, generally thought to be the most common cause of subcutaneous infections in addicts, was found only in four (19 percent) patients. The other aerobic isolates were Klebsiella (five) and Enterobacter (four) species. When clinical features or the Gram stain of pus suggest that anaerobic bacteria may be present, antibiotic therapy should be directed against both aerobic and anaerobic bacteria until culture results are available.
对21名入院的重症吸毒者的皮肤和软组织感染情况进行了研究。14例患者出现皮下脓肿；3例出现蜂窝织炎，2例出现脓性肌炎，2例出现坏死性筋膜炎。4例患者发生败血症。14例患者（66.6%）的感染与厌氧菌有关，其中6例患者的感染仅由厌氧菌引起。7例患者（33.3%）的分离菌仅为需氧菌，8例患者的分离菌中同时存在需氧菌和厌氧菌。厌氧菌分离株包括梭菌（6株）、消化链球菌（5株）、拟杆菌（5株）、消化球菌（3株），以及韦荣球菌、丙酸杆菌、真杆菌、梭杆菌和放线菌各1株。通常被认为是吸毒者皮下感染最常见原因的金黄色葡萄球菌，仅在4例（19%）患者中发现。其他需氧菌分离株为克雷伯菌属（5株）和肠杆菌属（4株）。当临床特征或脓液革兰氏染色提示可能存在厌氧菌时，在获得培养结果之前，抗生素治疗应针对需氧菌和厌氧菌。
