目的：分析糖尿病足部感染临床分离病原菌的分布及其抗菌药物敏感性特点，为临床合理应用抗菌药物提供理论依据。方法：选取2012年1月～2014年12月期间，在本院住院治疗的糖尿病足合并感染的患者95例，采集糖尿病足部溃疡分泌物，并保存培养分离出的病原菌，采用琼脂倍比稀释法进行药物敏感试验，药敏结果依据美国临床实验室标准化委员会2013年推荐的标准进行判读。结果：95例糖尿病足部感染患者的溃疡分泌物中，共培养分离出病原菌105株，其中，革兰阳性菌55株（52．4％），革兰阴性菌35株（33．3％），真菌15株（14．3％）。药敏试验表明，革兰阴性菌对以亚胺培南和美罗培南为代表的碳青霉烯类抗菌药物、含β－内酰胺酶抑制剂和阿米卡星的药物敏感性相对较高；革兰阳性菌对以万古霉素和替考拉宁为代表的糖肽类抗菌药物、碳青霉烯类和氨基糖苷类药物的敏感性相对较高；真菌则对两性霉素B和卡泊芬净敏感度最高。结论：感染是糖尿病足患者病情加重的一个重要因素，多重耐药菌的分离率较高，且随着糖尿病足部感染严重程度的增加，主导病原菌由革兰阳性菌向革兰阴性菌转变。%Objective:To analyze the clinical distribution and antimicrobial resistance of pathogens causing diabetic foot infections in order to provide the basis for clinical rational choice of antibiotics.Methods:95 cases of diabetic foot infection were chosen from January 2012 to December 2014.The antimi-crobial susceptibility test to isolated pathogens was performed by agar dilution method .The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2013.Results:Of 95 cases of diabetic foot infection, 105 strains were isolated, in which 55 were Gram-positive bacteria (52.4%), 35 Gram-negative bacteria (33.3%), and 15 fungi (14.3%).The results of antimicrobial susceptibility test showed that Gram-negative bacteria were highly susceptible to the carbapenem and β-lactamase inhibitor; Gram-positive bacteria were highly susceptible to the glycopeptide, carbapenem and aminoglycoside;fungus were susceptible to amphotericin B and caspofungin .Conclusion:Infection is an important factor in diabetic foot patients, and the rate of multi-drug resistance is high.With the increase in the severity of diabetic foot infections, the leading pathogens tran-sited from Gram-positive bacteria to Gram-negative bacteria.
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