基于Wagner分级糖尿病足感染的病原菌分布及药敏分析

发布时间：2018-01-05 00:12

本文关键词：基于Wagner分级糖尿病足感染的病原菌分布及药敏分析　出处：《重庆医科大学学报》2016年11期 　论文类型：期刊论文

【摘要】：目的:调查基于Wagner分级糖尿病足感染(diabetic foot infection,DFI)的病原菌分布及药敏情况。方法:回顾性调查重庆医科大学附属第一医院2014年1月至2016年1月收治的216例DFI患者,统计分析不同Wagner分级的DFI患者病足溃疡标本中培养的病原菌分布、多重耐药(multiple drug resistance,MDR)菌构成及其药敏结果。结果:分离出病原菌263株:单菌感染占57.4%,混合菌感染占42.6%;革兰阳性(G+)菌、革兰阴性(G-)菌和真菌分别占43.5%、48.1%和8.4%。Wagner分级患足细菌培养结果显示:2级:G+菌45株,金黄色葡萄球菌占48.9%,G-菌43株,肠杆菌占69.8%;3级:G+菌36株,肠球菌占47.2%,金黄色葡萄球菌占27.8%,G-菌44株,肠杆菌占72.7%;4级:G+菌24株,肠球菌占33.3%,金黄色葡萄球菌占25.0%,链球菌占25.0%,G-菌23株,肠杆菌占73.9%;5级:G+菌9株,肠球菌占66.7%,G-菌16株,肠杆菌占81.3%。不同Wagner分级患者G+菌和G-菌分布情况无统计学差异(P=0.526)。G+菌对万古霉素、利奈唑胺、莫西沙星、替加环素敏感性达75%以上,G-菌对碳青霉烯类、阿米卡星、抗假单胞菌青霉素类复方制剂、四代头孢菌素类、头霉素类敏感性达64%以上。结论:DFI患者总体上单一菌略多于混合菌感染,G-菌较G+菌感染分布略占优势。G+菌及G-菌对常用的抗G+菌及G-菌药物有较好敏感性。
[Abstract]:Objective: to investigate diabetic foot infection based on Wagner classification. Methods: a retrospective study was conducted on 216 patients with DFI admitted to the first affiliated Hospital of Chongqing Medical University from January 2014 to January 2016. The distribution of pathogenic bacteria in the specimens of foot ulcers from patients with DFI with different Wagner grades was statistically analyzed, and multiple multidrug resistant drug resistance was obtained. Results: 263 strains of pathogenic bacteria were isolated: single bacteria infection accounted for 57.4%, mixed bacteria infection accounted for 42.6%; Gram-positive G), Gram-negative G) and fungi accounted for 43.5% respectively. The results of 48.1% and 8.4. Wagner's grading showed that 45 strains of G strain were in grade 2 and 43 strains were Staphylococcus aureus. Enterobacterium accounted for 69.8%; 36 strains of grade 3: G, 47.2% of Enterococcus, 27.8% of Staphylococcus aureus and 72.7% of Enterobacter; 24 strains of grade 4: G, 33.3% of Enterococcus, 25.0 of Staphylococcus aureus, 23 of Streptococcus sp., and 73.9 of Enterobacter; There were 9 strains of grade 5 G and 16 strains of Enterococcus. Enterobacterium accounted for 81.3. There was no statistical difference in the distribution of G and G- bacteria in patients with different Wagner grades. There was no significant difference in the distribution of G and G- bacteria against vancomycin, linazolamine and moxifloxacin. The sensitivity of tegicycline to carbapenem, amikacin, penicillin compound preparation and cephalosporins of four generations were more than 75%. The sensitivity of cephalomycin is more than 64%. Conclusion in general, the single bacteria is slightly more than mixed bacteria infection in the patients with head DFI. The distribution of G- bacteria was a little higher than that of G-bacteria. G and G-bacteria were more sensitive to G-resistant and G-bacteria drugs.
【作者单位】：重庆医科大学附属第一医院药学部;重庆医科大学附属第一医院内分泌科;
【分类号】：R587.2
【正文快照】： 糖尿病足病最常见的形式是足溃疡,糖尿病患者发生足溃疡的风险高达25%[1]。我国多中心调查数据证实,糖尿病足溃疡患者约有70%合并感染[2]。糖尿病足溃疡感染的早期诊断和规范治疗,不仅可提高抗感染疗效、促进溃疡愈合,也是保肢的基本措施和节省医疗费用的有效途径。明确糖尿病

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