摘要目的:探讨皮肤软组织感染患者病原菌分布情况及对常用抗菌药物的耐药性。方法:该研究为横断面调查。回顾性纳入2020年4月至2021年4月于杭州米兰柏羽美容医院就诊的皮肤软组织感染患者120例，男65例、女55例，年龄21～64(44.4±3.2)岁。收集患者创面脓液或分泌物标本送检并进行细菌分离鉴定和药敏试验，观察病原菌分布情况及对常用抗菌药物的耐药性。结果:120例皮肤软组织感染患者共分离出140株病原菌，其中76株(54.29%)革兰阳性菌，51株(36.43%)革兰阴性菌，13株(9.29%)真菌。在细菌耐药方面，金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌3种革兰阳性菌对青霉素、红霉素、氨苄西林/舒巴坦耐药率较高。金黄色葡萄球菌对青霉素耐药率71.05%，红霉素耐药率63.16%，氨苄西林/舒巴坦耐药率42.11%。表皮葡萄球菌对青霉素耐药率100%，红霉素耐药率57.89%，氨苄西林/舒巴坦耐药率47.37%。溶血葡萄球菌对青霉素耐药率70.00%，红霉素耐药率50.00%，氨苄西林/舒巴坦耐药率50.00%。金黄色葡萄球菌对呋喃妥因、利奈唑胺、万古霉素耐药率均为0。表皮葡萄球菌对呋喃妥因和万古霉素耐药率均为0，利奈唑胺耐药率15.79%。溶血葡萄球菌对呋喃妥因、利奈唑胺、万古霉素耐药率均为0。大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌3种革兰阴性菌对红霉素、环丙沙星、氧氟沙星、庆大霉素耐药率较高。大肠埃希菌对红霉素耐药率80.00%，环丙沙星耐药率64.00%，氧氟沙星耐药率60.00%，庆大霉素耐药率52.00%。铜绿假单胞菌对红霉素耐药率46.15%，环丙沙星耐药率46.15，氧氟沙星耐药率38.46%，庆大霉素耐药率38.46%。肺炎克雷伯菌对红霉素耐药率57.14%，环丙沙星耐药率42.86%，氧氟沙星耐药率42.86%，庆大霉素耐药率48.86%。对阿米卡星、美罗培南耐药率较低，大肠埃希菌对阿米卡星耐药率16.00%，美罗培南耐药率4.00%。铜绿假单胞菌对阿米卡星耐药率7.69%，美罗培南耐药率为0。肺炎克雷伯菌对阿米卡星耐药率为14.29%，美罗培南的耐药率为0。结论:皮肤软组织感染患者病原菌以革兰阳性菌多见，对多种抗菌药物存在不同的耐药现象。

abstractsObjective:To investigate the distribution of pathogens and resistance to commonly used antimicrobial drugs in patients with skin and soft tissue infection.Methods:It was a cross-sectional study from April 2020 to April 2021, 120 patients with skin and soft tissue infection, including 65 males and 55 females, aged 21 to 64 (44.4±3.2) years. The wound pus or secretion samples were collected for inspection and bacterial isolation and identification and drug susceptibility test to observe the distribution of pathogens and resistance to commonly used antimicrobial drugs.Results:A total of 140 pathogens were isolated from 120 patients with skin and soft tissue infection, including 76 Gram (54.29%) positive, 51 Gram (36.43%) negative bacteria and 13 fungus (9.29%). In terms of bacterial resistance, the three main Gram-positive bacteria, Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus haemolyticus had high rates of drug resistance: 71.05% Staphylococcus aureus were resistance to ampicillin/sulbactam; 63.16 to erythromycin, and 42.11 to ampicillin/sulbactam; S. epidermidis showed 100% resistant to penicillin, 57.89% to erythromycin, and 47.37% to ampicillin/sulbactam; the resistance of Staphylococcus haemolyticus was 70% to penicillin, 50% to erythromycin, 50% to ampicillin/sulbactam; Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus showed low resistance to nitrofurantoin, linezolid, and vancomycin. S. aureus showed 0% resistance to nitrofurantoin, 0% to linecolamine, and 0% to vancomycin. Staphylococcus epidermidis was 0% resistant to nitrofurantoin and 15.79% resistant to linezolid; S. haemolyticus showed 0% resistance to nitrofurantoin, linecolamine and vancomycin. Three main Gram-negative bacteria, Escherichia coli, Pseudomonas aeruginosa, and K. pneumoniae, showed high resistance to erythromycin, ciprofloxacin, ofloxacin, and gentamicin. E. coli showed 80% resistance to erythromycin, 64% to ciprofloxacin, 60% to ofloxacin, and 52% to gentamicin. P. aeruginosa showed 46.15% resistance to erythromycin, 46.15 to ciprofloxacin, 38.46% to ofloxacin, and 38.46% to gentamicin. Klebsiella pneumoniae showed resistance to erythromycin (57.14%), ciprofloxacin (42.86%), ofloxacin (42.86%), and gentamicin (48.86%); 16% Escherichia coli were resistant to amikacin and 4% to meropenem. P. aeruginosa showed 7.69% were resistant to amikacin and 0% to Amikacin; Amikacin resistance in K. pneumoniae was 14.29% and 0 for meropenem.Conclusions:The pathogenic bacteria in patients with skin and soft tissue infection are often Gram-positive, and there are different resistance phenomena to various antimicrobial drugs. In clinical use, antibiotics should be rationally selected combined with the results of drug sensitivity test to reduce the bacterial drug resistance.