Objective To investigate the clinical features of staphylococcal scalded skin syndrome (SSSS) and the drug resistance of Staphylococcus aureus (S. aureu) for improving clinical diagnosis and guiding clinical medica-tion. Methods The clinical features, bacterial culture and drug sensitivity results of 50 hospitalized cases with SSSS from July, 2009 to June, 2015 in Hainan Provincial Hospital of Skin Disease were included and retrospectively re-viewed. Results Among the 50 cases, SSSS most commonly affected less than 5 years old children (44 cases, 88.0%) and was associated with upper respiratory tract infections (20 cases, 40.0%) or impetigo (12 cases, 24.0%) during the summer and autumn (37 cases, 74.0%). All children had a fever at the onset of the disease (100.0%). Face was most com-monly and initially involved, and mucosa was not involved in all the children. Twelve of 50 patients (24.0%) were misdi-agnosed. S. aureu strains were isolated from wound secretion or pharyngeal swab culture of 40 children (80.0%), one of which was Methicillin-resistant Staphylococcus aureus (MRSA). Forty strains of Staphylococcus aureus were cultured for in vitro drug sensitivity test. The results showed that the susceptibility rates to oxacillin, cefazolin and vancomycin were 82.5%(33/40), 92.5%(37/40) and 100.0%(40/40), and the resistance rate to penicillin, erythromycin, clindamycin were 100.0%(40/40), 100.0%(40/40), 70.0%(28/40), respectively. Conclusion SSSS is easy to be misdiagnosed, and the di-agnostic accuracy can be improved by mastering the clinical features of the disease. Pathogenic strains of S. aureu were highly resistant to penicillin, erythromycin and clindamycin, while were susceptible to oxacillin, cefazolin and vancomy-cin. According to the drug sensitivity results, early application of sensitive antibiotics can effectively alleviate the disease.%目的 探讨葡萄球菌烫伤样皮肤综合征(SSSS)的临床特点及金黄色葡萄球菌的耐药情况,以提高临床诊断及指导临床用药.方法 回顾分析我院2009年7月至2015年6月收治的50例SSSS患儿的临床诊治资料和细菌培养及药敏结果.结果 50例葡萄球菌烫伤样皮肤综合征患儿发病年龄多在5岁以下(44例,88.0%),夏秋季多见(37例,74.0%),常见诱发因素为上呼吸道感染(20例,40.0%)和脓疱疮(12例,24.0%).患儿起病时均有发热(100.0%),皮损最容易累及和最早累及的部位为面部,所有患儿黏膜未受累.临床误诊率达24.0%(12/50).80.0%(40/50)的患儿创面分泌物或咽拭子培养检出金黄色葡萄球菌,其中一株为耐甲氧西林金黄色葡萄球菌.对培养的40株金葡菌进行体外药物敏感性试验,结果显示苯唑西林、头孢唑啉、万古霉素敏感性分别为82.5%(33/40)、92.5%(37/40)、100.0%(40/40),青霉素、红霉素、克林霉素耐药率分别为100.0%(40/40)、100.0%(40/40)、70.0%(28/40).及时应用头孢唑啉治疗后,98.0%的患儿4~8 d痊愈出院.结论 葡萄球菌烫伤样皮肤综合征临床易于误诊,掌握该病临床特点可提高诊断准确率.致病菌金葡菌对青霉素、红霉素、克林霉素高度耐药,对苯唑西林、头孢唑啉、万古霉素敏感.根据药敏结果,及早应用敏感抗生素治疗能有效缓解病情.
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