糖尿病足感染患者病原菌分布及耐药性分析

摘要

目的：分析糖尿病足患者感染常见病原菌分布及耐药情况，指导临床合理用药。方法回顾性调查分析我院收治的83例糖尿病足感染患者创面分泌物病原菌分离培养及其耐药状况。结果83例糖尿病足感染患者70例培养出病原菌，占84％（70/83），13例未见细菌生长，占16％（13/83）。共培养出病原菌82株，其中革兰阳性菌42株（51％），以葡萄球菌属最为多见；革兰阴性菌39株（48％），其中以肠杆菌科细菌最为多见，真菌1株（1％）。革兰阳性菌中多重耐药菌株比例较高，占33％；革兰阴性菌中多重耐药菌株较少，占10％。革兰阳性菌对万古霉素、利奈唑烷、氯霉素、利福平、庆大霉素、四环素类抗菌药较敏感，对青霉素、红霉素、克林霉素有一定的耐药性。革兰阴性菌对亚胺培南、氨基糖苷类、β-内酰胺酶及第2、3代头孢菌素类较敏感，对青霉素及第1代头孢菌素类耐药性高。结论糖尿病足患者感染病原菌分布广泛，应及时多次对糖尿病足感染进行创面细菌培养及药物敏感性试验，及时调整抗菌药物，减少耐药菌的产生，以利于促进创面早期愈合，降低糖尿病足截肢（趾）率。%Objective To analyze the spectrum and drug-resistance of pathogenic bacteria isolated from pa-tients with diabetic foot to instruct application of the antibiotics reasonably .Methods Isolated strains and their drug resistance from 83 patients with infected diabetic foot were retrospectively studied in our hospital .Results Eighty-two strains were isolated from 83 patients with diabetic foot .Seventy cases with bacterial growth ,account-ing for 84% ;13 cases no bacterial growth ,accounting for 16% .In 82 strains ,Gram-positive strains were 42 str-atins (51% ) ,in which staphylococcus aureus were most common ,Gram-negative strains were 39 stratins (48% ) , in which enterobacteriaceae were most common ,fungi strains was 1 stratins (1% ) .Multidrug-resistant strains were more higher in gram positive bacteria (33% ) than in gram negative bacteria(10% ) .Gram positive bacteria is sensitive to vancomycin ,linezolid ,chloramphenicol ,rifampicin ,gentamicin and tetracycline antibiotic ,but it has drug-resistance to penicillin ,erythromycin ,clindamycin .Gram negative bacteria is sensitive to Imipenem ,amin-oglycosides ,beta lactamase ,the 2nd ,3th generation cephalosporins ,but it has drug-resistance to Penicillin and the first generation cephalosporins .Conclusion Distribution of pathogenic bacteria in patients with diabetic foot infec-tion is wide .Pathogenic bacteria and its drug resistance should be timely and repeatedly monitored to adjust antibi-otics and reduce the generation of antibiotic resistant bacteria ,in order to promote wound healing of diabetes and reduce foot amputation (toe) rate .