Brook I, Frazier E H, Yeager J K
Department of Pediatrics, Naval Hospital, Bethesda, Maryland, USA.
Int J Dermatol. 1996 Nov;35(11):791-3. doi: 10.1111/j.1365-4362.1996.tb02975.x.
Bacterial infections occur frequently in lesions of atopic dermatitis (AD). The objectives of the study were to establish the aerobic and anaerobic microbiology of secondarily infected AD.
A retrospective review was carried out of clinical and microbiology laboratory records and of data obtained from patients with secondarily infected AD lesions, whose specimens of infected sites were processed for the presence of aerobic and anaerobic bacteria.
Bacterial growth was noted in 41 specimens. Aerobic or facultative anaerobic bacteria only were present in 15 patients (36%), anaerobic bacteria only in eight (20%), and mixed anaerobic-aerobic flora was present in 18 (44%). Seventy-two isolates were recovered (1.8 per specimen), 34 aerobic or facultative bacteria, 35 strict anaerobes, and three Candida sp. The predominant aerobic and facultative bacteria were Staphylococcus aureus (12 isolates), Group A beta hemolytic streptococcus in five isolates, and Escherichia coli in four. The predominant anaerobes were Peptostreptococcus spp. (13 isolates), pigmented Prevotella and Porphyromonas spp. in eight, and Fusobacterium spp. in four isolates. Single bacterial isolates were recovered in 14 patients (34%), seven of which were S. aureus. Twenty-one of the organisms isolated from 16 patients (39%) produced the enzyme beta-lactamase. Organisms that resided in the mucous membranes close to the lesions predominated in these infections. Enteric gram-negative rods and Bacteroides fragilis group predominated in lesions on legs and buttocks. Group A beta-hemolytic streptococci, pigmented Prevotella, and Porphyromonas and Fusobacterium spp. were most frequently recovered in lesions of the finger, scalp, face, and neck.
The polymicrobial etiology of secondarily infected AD lesions and the association of bacterial flora with the anatomic site of the lesions are demonstrated.
特应性皮炎（AD）皮损中细菌感染很常见。本研究的目的是确定继发感染的AD的需氧和厌氧微生物学情况。
对继发感染的AD皮损患者的临床和微生物学实验室记录以及所获数据进行回顾性分析，对其感染部位的标本进行需氧和厌氧菌检测。
41份标本中有细菌生长。仅需氧菌或兼性厌氧菌存在于15例患者中（36%），仅厌氧菌存在于8例患者中（20%），需氧菌和厌氧菌混合菌群存在于18例患者中（44%）。共分离出72株菌（每份标本1.8株），34株需氧菌或兼性菌，35株严格厌氧菌，3株念珠菌属。主要的需氧菌和兼性菌为金黄色葡萄球菌（12株）、A组β溶血性链球菌5株、大肠杆菌4株。主要的厌氧菌为消化链球菌属（13株）、产色素普雷沃菌属和卟啉单胞菌属8株、梭杆菌属4株。14例患者（34%）分离出单一菌株，其中7株为金黄色葡萄球菌。从16例患者（39%）分离出的菌株中有21株产生β-内酰胺酶。这些感染中以病变部位附近黏膜中的细菌为主。肠道革兰氏阴性杆菌和脆弱拟杆菌群在腿部和臀部皮损中占主导。A组β溶血性链球菌、产色素普雷沃菌属、卟啉单胞菌属和梭杆菌属在手指、头皮、面部和颈部皮损中最常分离到。
证实了继发感染的AD皮损的多微生物病因以及菌群与皮损解剖部位的关联。
