天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (4): 390-394.doi: 10.11958/20253187

• 临床研究 • 上一篇    下一篇

金黄色葡萄球菌在皮肤软组织感染中的耐药性及危险因素分析

王景艳1(), 王彦2, 王敬2, 苏维2, 王红蕾2△()   

  1. 1 河北大学附属医院大外科（邮编071000）
    2 河北大学附属医院检验科（邮编071000）
  • 收稿日期:2025-10-22 修回日期:2026-01-22 出版日期:2026-04-15 发布日期:2026-04-14
  • 通讯作者: △E-mail：whlhdfy@163.com
  • 作者简介:王景艳（1972），女，副主任护师，主要从事护理管理及危重症病人护理方面研究。E-mail：947442534@qq.com
  • 基金资助:
    河北省卫生健康委医学科学研究课题计划项目(20260731)

Drug resistance and risk factors of Staphylococcus aureus in skin and soft tissue infections

WANG Jingyan1(), WANG Yan2, WANG Jing2, SU Wei2, WANG Honglei2△()   

  1. 1 Department of Major Surgery, Affiliated Hospital of Hebei University, Baoding 071000, China
    2 Department of Laboratory Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China
  • Received:2025-10-22 Revised:2026-01-22 Published:2026-04-15 Online:2026-04-14
  • Contact: △E-mail：whlhdfy@163.com

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摘要：

目的 探讨皮肤软组织感染（SSTIs）患者金黄色葡萄球菌（SA）的病原特征及耐药性，并分析感染耐甲氧西林金黄色葡萄球菌（MRSA）的危险因素。方法 选取因SSTIs住院且其分泌物或引流液培养为SA的患者110例。收集患者的临床资料，统计SA的感染情况、抗菌药物敏感性病原菌耐药基因检测情况，多因素Logistic回归分析SSTIs患者感染MRSA的影响因素。结果 共分离出110株SSTIs相关SA分离株，其中MRSA分离株27例（24.5%）。与甲氧西林敏感的金黄色葡萄球菌（MSSA）组（83例）比较，MRSA组入院前门诊抗生素治疗、mecA基因携带率较高（P<0.05）。SA对青霉素的耐药率最高（94.5%），其次对红霉素的耐药率较高（58.2%），对利福平的耐药率较低（0.9%），未产生对利奈唑胺、替加环素、万古霉素、达托霉素、替考拉宁的耐药。与MSSA组比较，MRSA组对苯唑西林、四环素、米诺环素及左氧氟沙星的耐药率较高（P<0.05）。Logistic回归分析显示，入院前门诊抗生素治疗与发热是SSTIs患者感染MRSA的危险因素（P<0.05）。结论 SSTIs中SA的耐药谱存在差异，MRSA菌株表现出广泛的多重耐药性，且入院前门诊抗生素治疗和发热的SSTIs患者更易出现MRSA感染。

关键词: 金黄色葡萄球菌, 耐甲氧西林金黄色葡萄球菌, 抗菌药, 皮肤和软组织感染, 耐药性, 危险因素

Abstract:

Objective To explore the pathogenic characteristics and drug resistance of Staphylococcus aureus (SA) in patients with skin and soft tissue infections (SSTIs), and to analyze the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection. Methods A total of 110 patients who were hospitalized due to SSTIs and whose secretions or drainage fluid were cultured as SA were selected. The clinical data of the patients were collected, and the status of patients with SA infection, the antibiotics sensitivity of the SA strains and the carrying rate of drug-resistant genes were statistically analyzed. Multivariate Logistic regression was used to analyze the influencing factors of MRSA infection in SSTIs patients. Results A total of 110 SSTIs-related SA isolates were isolated, among which 27 isolates (24.5%) were MRSA. Compared with the methicillin-sensitive Staphylococcus aureus (MSSA) group, the MRSA group had a higher proportion of outpatient antibiotic treatment before admission and mecA gene carriage rate (P<0.05). The resistance rate of SA to penicillin was the highest (94.5%), followed by erythromycin (58.2%), and the resistance rate to rifampicin was the lowest (0.9%). Resistance to linezolid, tigecycline, vancomycin, daptomycin and teicoplanin was not observed. Compared with the MSSA group, the MRSA group had a higher resistance rate to oxacillin, tetracycline, minocycline and levofloxacin (P<0.05). Logistic regression analysis showed that outpatient antibiotic treatment before admission and fever were risk factors for MRSA infection in SSTIs patients (P<0.05). Conclusion The drug resistance spectrum of SA in SSTIs is different, and MRSA strains show extensive multi-drug resistance. SSTIs patients with outpatient antibiotic treatment and fever before admission are more likely to have MRSA infection.

Key words: Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, anti-bacterial agents, skin and soft tissue infections, drug resistance, risk factors

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