糖尿病足患者伤口感染的病原菌分布及药敏结果分析

发布时间：2018-01-01 01:08

本文关键词：糖尿病足患者伤口感染的病原菌分布及药敏结果分析　出处：《中华医院感染学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的了解糖尿病足患者伤口感染标本的病原菌分布及药敏情况,为临床治疗提供病原学依据。方法选择2015年3月-2016年7月在医院住院治疗的120例糖尿病足伤口感染患者,采集患者伤口深部分泌物送检,对送检标本进行病原菌培养及药敏试验,药敏结果依据美国临床实验室标准化委员会(CLSI)相关标准进行判读。结果 120例糖尿病足伤口感染患者的送检标本中共培养出病原菌118株,其中革兰阳性菌73株占61.9%,以金黄色葡萄球菌和表皮葡萄球菌为主,革兰阴性菌37株占31.3%,以奇异变形菌和肺炎克雷伯菌为主,真菌8株占6.8%;革兰阳性菌对替考拉宁和万古霉素的敏感率为100.0%,其次为米诺环素、呋喃妥因,主要革兰阳性菌对诺氟沙星、苯唑西林、庆大霉素及青霉素的耐药率在27.8%~77.8%;革兰阴性菌对美罗培南、头孢他啶及亚胺培南/西司他丁的敏感率在75.0%~88.9%,而对头孢噻吩、头孢呋辛及替卡西林的耐药率在30.0%以下;真菌中白假丝酵母对氟康唑和伊曲康唑的耐药率在25.0%~50.0%。结论糖尿病足伤口感染患者治疗时,要依据病原菌分布及药敏试验结果合理选择抗菌药物,同时为了避免病原菌种类及其抗菌药物敏感性的变化,在治疗期间要多次对患者病足创面进行病原菌培养和药敏试验,及时、合理的调整用药,以促进患者病足创面的愈合,改善患者预后和生活质量,降低糖尿病足的致残率及致死率。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug sensitivity in wound infection specimens of diabetic foot patients. Methods 120 patients with diabetic foot wound infection who were hospitalized in hospital from March 2015 to July 2016 were selected and their deep secretions were collected for examination. The pathogen culture and drug sensitivity test were carried out. Results 118 strains of pathogenic bacteria were cultured in 120 patients with diabetic foot wound infection. Among them, 73 strains of Gram-positive bacteria accounted for 61.9%, mainly Staphylococcus aureus and Staphylococcus epidermidis, 37 strains of Gram-negative bacteria accounted for 31.3%, and the main strains were Proteus mirabilis and Klebsiella pneumoniae. 8 strains of fungi accounted for 6.8%; The sensitivity rate of Gram-positive bacteria to teicoplanin and vancomycin was 100.0, followed by minocycline and furantoin, and the main gram-positive bacteria were norfloxacin and oxacillin. The drug resistance rates of gentamicin and penicillin were 27.8% and 77.8% respectively. The sensitivity rate of Gram-negative bacteria to meropenem, ceftazidime and imipenem / cilastatin was 75.0 / 88.9, while to cefalothiophene. The drug resistance rates of cefuroxime and ticacillin were below 30.0%; The resistance rate of Candida albicans to fluconazole and itraconazole was 25.0 or 50.0.Conclusion in the treatment of diabetic foot wound infection patients. Antibiotics should be reasonably selected according to the distribution of pathogens and the results of antimicrobial susceptibility test, and in order to avoid the change of pathogen species and antimicrobial susceptibility. In order to promote the healing of foot wounds and improve the prognosis and quality of life, the pathogen culture and drug sensitivity test should be carried out many times during the treatment. To reduce the disability rate and mortality of diabetic foot.
【作者单位】：贵州省兴义市人民医院护理部;贵州省兴义市人民医院检验科;贵州省兴义市人民医院内分泌科;贵州省兴义市人民医院手术室;贵州省兴义市人民医院门诊部;
【基金】：贵州省科技厅基金资助项目[黔科合SY字(2011)89713]
【分类号】：R446.5;R587.2
【正文快照】： 糖尿病足是糖尿病患者晚期最严重的慢性并发症之一,糖尿病足其主要是由于糖尿病患者血管病变或(和)神经病变以及感染等因素,导致患者足部或下肢组织破坏的一种病变[1]。糖尿病足伤口的破溃流脓感染,是目前临床治疗的重点和难点,也是糖尿病患者晚期致残、致死的主要原因。相关

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