耐甲氧西林金黄色葡萄球菌感染对糖尿病足患者预后的影响

摘要

目的：探讨耐甲氧西林金黄色葡萄球菌(MRSA)感染对糖尿病足患者预后的影响。方法选取我院2013年2月~2015年2月收治的金黄色葡萄球菌阳性糖尿病足患者92例,根据耐药试验分为 MRSA 组(45例,病原菌为 MRSA)和 MSSA 组(47例,病原菌为甲氧西林敏感金黄色葡萄球菌)。比较2组一般资料、血生化指标、治疗方案及预后。结果①比较 MSSA 组、MR-SA 组溃疡病程较长,溃疡面积较大,Wagner 分级和感染严重程度分度均较重(P <0.05)；②比较 MSSA 组、MRSA 组 WBC 与hs-CRP 水平较高,ALB 水平较低(P <0.05)；③MRSA 组手术治疗人数较 MSSA 组多,2组除5例患者(MRSA 组3例,MSSA组2例)因病情严重拒绝继续治疗,其余患者均痊愈或好转后出院。结论MRSA 感染糖尿病足患者溃疡病程长、溃疡面积较大,全身炎症反应较重,及时进行正确的细菌培养及药敏检测,展开积极对症治疗,可取得良好预后。%Objective To investigate the effect of Staphylococcus aureus (MRSA)infection on the prognosis of diabetic foot patients. Methods In our hospital from February 2013 to February 201 5,92 cases of Staphylococcus aureus positive diabetic foot were se-lected.According to drug resistance test,they were divided into MRSA group (45 cases,pathogenic bacteria was MRSA)and MSSA group (47 cases,pathogenic bacteria was Staphylococcus aureus ).The general information,blood biochemical indicators, treatment plan and prognosis were compared between groups.Results ALB and Wagner levels were significantly higher in MSSA group(P <0.05);WBC was significantly higher than that in MRSA group (P <0.05);Except for (MRSA group,3 cases,MSSA group,2 cases)all patients were recoved.Conclusion MRSA infection in diabetic foot patients with long ulcer,large ulcer area,seri-ous systemic inflammatory response is more important than MSSA infection.Timely and correctly bacterial culturing and drug sen-sitivity testing,and actively symptomatic treatment can achieve good prognosis.