中国麻风皮肤病杂志 ›› 2019, Vol. 35 ›› Issue (9): 515-519.doi: 10.12144/zgmfskin201909515

• 论著 • 上一篇    下一篇

我国痤疮患者皮损中痤疮丙酸杆菌对抗生素耐药性的Meta分析

张丽媛1  王奇飒2  朱纹懿3  吕乐春4  杨斐1  颜仕立1  李国星1  王玉兰1  李艳1  刘金菊5  孙东杰1   

  1. 1昆明医科大学第一附属医院，云南昆明，650032
    2北京市顺义区妇幼保健院，北京市儿童医院顺义妇儿医院，北京，101300
    3红河卫生职业学院，云南蒙自，661199
    4昆明医科大学技术转移中心，云南昆明，650500
    5湖南省湘西自治州人民医院，湖南湘西，416000
  • 出版日期:2019-09-15 发布日期:2019-09-11
  • 通讯作者: 孙东杰，E-mail: 412633947@qq.com

Systematic evaluation of positivity rates to antibiotic resistance of Propionibacterium acnes isolated from lesions of patients with acne in China

ZHANG Liyuan1, WANG Qisa2, ZHU Wenyi3, LYU Lechun4, YANG Fei1, YAN Shili1, LI Guoxing1, WANG Yulan1, LI yan1, LIU Jinju5, SUN Dongjie1   

  1. 1. The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; 2. Shunyi District Maternal and Child's Hospital of Beijing Child's Hospital, Beijing 101300, China; 3. Honghe Health Vocational College, Mengzi 661199, China; 4. Kuming Medical University Technology Transfer Center, Kunming 650500, China; 5. Xiangxi Autonomous Prefecture People's Hospital，Xiangxi 416000, China
  • Online:2019-09-15 Published:2019-09-11
  • Contact: Sun Dongjie, E-mail: 412633947@qq.com

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摘要： 目的：系统评价我国痤疮患者的皮损分离的痤疮丙酸杆菌(P.acnes)对抗生素的耐药情况，为痤疮抗生素合理治疗提供临床依据。方法：计算机网络检索中国知网(CNKI)、中文科技期刊文数据库(VIP)、万方数据库和PubMed中的相关研究，收集痤疮皮损分离痤疮丙酸杆菌对四环素类、大环内酯类等抗菌药物耐药率的相关研究，对符合纳入标准研究资料进行提取，采用R语言3.3.2 Meta程序包进行Meta分析。结果：共纳入文章13篇，合计1770例痤疮患者，共分离痤疮丙酸杆菌合计1259株。对我国P.acnes的抗生素耐药率进行单组率Meta分析，结果显示P.acnes对红霉素、克拉霉素、阿奇霉素耐药率分别为：45%（95% CI 0.35～0.58)，74%（95% CI 0.51～0.89)，59%（95% CI 0.33～0.84)；对米诺环素、多西环素、四环素耐药率分别为：2%（95% CI 0.00～0.07)，6%（95% CI 0.00～0.26)，8%（95% CI 0.00～0.24)；对甲硝唑耐药率为96%（95% CI 0.80～1.00）。不同抗生素之间存在交叉耐药。结论：我国痤疮患者皮损分离的P.acnes对大环内酯类及甲硝唑耐药率高，对四环素类、喹诺酮类抗生素较为敏感，其中以米诺环素敏感性最高。

关键词: 痤疮, 痤疮丙酸杆菌, 抗生素耐药, 系统分析

Abstract: Objective: To systematically evaluate the positivity rates to antimicrobial agents of Propionibacterium acnes (P.acnes) isolated from patients with acne in China and to provide a clinical reference for the antibiotic therapy of acne. Methods: The relevant studies were searched from CNKI, Quotation Databases of Chinese Science and Technology Periodical (VIP), Wanfang Data and PubMed and analyzed with Meta analysis through R3.3.2 Meta software package. Results: A total of 13 articles were enrolled, including 1770 patients with acne, 1259 bacterial strains of P.acnes. The drug resistance rates of P.acnes to Erythromycin, Clarithromycin, Azithromycin were 45%（95% CI 0.35～0.58)，74%（95% CI 0.51～0.89)，59%（95% CI 0.33～0.84) respectively；the drug resistance rates of P.acnes to minocycline, doxycycline, tetracycline were 2%（95% CI 0.00～0.07)，6%（95% CI 0.00～0.26)，8%（95% CI 0.00～0.24) respectively；the drug resistance rate of P.acnes to Metronidazole was 96% (95% CI 0.80～1.00) and there was cross resistance between different antibiotic classes. Conclusion: There was a high drug resistance rates of P.acnes isolated from patients with acne to macrolides and Metronidazoles and P.acnes was sensitive to etracyclines, minocycline was at maximum sensitivity.

Key words: acne, propionibacterium acnes, positivity to antimicrobial agents, systematic analysis