Nhiễm khuẩn bệnh viện trên bệnh nhân hội chứng Stevens - Johnson và hoại tử thượng bì nhiễm độc điều trị nội trú tại Bệnh viện Da liễu thành phố Hồ Chí Minh

Abstract

Objective: To survey the infective, nosocomical infection, microbe, and antimicrobial resistance in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Subject and method: The cross-sectional study involved 51 SJS/TEN patients hospitalized in Ho Chi Minh City Hospital of Dermato - Venereology from 15/5/2018 to 15/10/2019. They were cultured skin lesion, blood and did antibiogram at the hospitalised time and the first nosocomial infection. Result: The study consisted of 58.8% male, mean age 45.8 ± 18.4 years old; SJS 33.3%, SJS/TEN 49%, TEN 17.6% and 49% with infection at the hospitalised time. Cultured 32 skin lesion patients: 40.6% infected with one bacteria, two bacteria 12.5%, methicillin-resistant Staphylococcus aureus (33.3%), methicillin-resistant Staphylococcus epidermidis (23.8%), P. aeruginosa (14.3%) more frequently identified pathogenic organisms. 2/29 blood cultured (+). Methicillin-resistant Staphylococcus aureus resistanced 100% with penicilline, cefoxitin, 85.7% with clindamycin, gentamycine. Methicillin-resistant Staphylococcus epidermidis resistanced 100% with penicilline, cefoxitin, 80% resistanced erythromycin, tetracycline. 2/3 patients infected P. aeruginosa resistanced with gentamycine. There was nosocomial infection, mean hospital stay was 10.1 ± 4.4 days. Conclusion: Should culture skin lesions of SJS/TEN patients and do antibiogram at the hospitalised time.  Methicillin-resistant Staphylococcus aureus, methicillin-resistant Staphylococcus epidermidis and P. aeruginosa more frequently identified pathogenic organisms, and when using antimicrobial therapy should be noticed the antimicrobial resistance.

Keywords: Stevens-Johnson syndrome, toxic epidermal necrolysis, infection, antimicrobial resistance.