抗生素局部使用对皮肤菌群的影响

Title：

Topical Decolonization Does Not Eradicate the Skin Microbiota of Community-Dwelling or Hospitalized Adults

DOI：

10.1128/AAC.01289-16

Abstract：

Topical antimicrobials are often employed for decolonization and infection prevention and may alter the endogenous microbiota of the skin. The objective of this study was to compare the microbial community, richness, and diversity in community-dwelling subjects and intensive care unit (ICU) patients before and after the use of topical decolonization protocols. We enrolled 15 adults at risk for Staphylococcus aureus infection. Community subjects (n=8) underwent a 5-day decolonization protocol (twice daily intranasal mupirocin and daily dilute bleach water baths) and ICU patients (n=7) received daily chlorhexidine baths. Swab samples were collected from 5 anatomic sites immediately before, and again after, decolonization. A variety of culture media and incubation environments were used to recover bacteria and fungi; isolates were identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Overall, 174 unique organisms were recovered. Unique communities of organisms were recovered from the community-dwelling and hospitalized cohorts. In the community-dwelling cohort, microbial richness and diversity did not differ significantly between collections across time points, although the number of body sites colonized with S. aureus significantly decreased over time (P=0.004). Within the hospitalized cohort, richness and diversity decreased over time compared to the enrollment sampling (from enrollment to final sampling, P=0.01 for both richness and diversity). Topical antimicrobials reduced the burden of S. aureus while preserving other components of the skin and nasal microbiota.

All Authors：

Carey-Ann D Burnham,Patrick G Hogan,Meghan A Wallace,Elena Deych,William Shannon,David K Warren,Stephanie A Fritz

First Authors：

Carey-Ann D Burnham

Correspondence：

Stephanie A Fritz

内容要点：

1、局部抗生素通常用于去定殖及预防感染，可能影响内源性皮肤微生物组；

2、选取8名社区居民，连续进行5天的去定殖步骤；以及7名ICU病人，每天接受洗必泰浴；

3、在身体的5个不同部位收集去定殖之前及之后的拭子样本；

4、在社区居民中，去定殖之前及之后的微生物多样性无显著差异，去定殖后金黄色葡萄球菌显著减少；

5、在ICU病人中，去定殖后微生物多样性及丰度降低。