糖尿病足患者感染病原学特点及药敏分析

发布时间：2018-04-05 12:48

  本文选题：糖尿病足　切入点：TASC分级　出处：《中华医院感染学杂志》2017年20期

【摘要】：目的探讨细菌感染对糖尿病足患者下肢血管病情的影响。方法收集2015年6月-2016年8月于医院住院治疗的糖尿病足伴细菌感染患者88例,依据泛大西洋学会联盟(TASC)分级(A~D)将患者分为A组24例、B组25例、C组20例、D组19例。比较四组患者间一般资料和实验室检查指标如踝肱指数(ABI)、趾肱指数(TBI)、白细胞计数等;收集患者足部溃疡分泌物做细菌培养和药敏实验。结果从A组到D组,患者年龄、病程、中性粒细胞比例逐渐增加(P0.05),ABI和TBI逐渐降低(P0.05),重度感染比例、混合感染比例逐渐上升(P0.05);细菌培养共检出病原菌195株,其中革兰阴性菌102株占52.31%,革兰阳性菌79株占40.51%,真菌14株占7.18%;药敏结果显示,主要革兰阴性菌对阿米卡星、亚胺培南等抗菌药物较敏感,主要革兰阳性菌均对达福普丁和万古霉素等较敏感。结论糖尿病足患者下肢感染与血管病变明显相关,随着下肢血管病变发展,混合感染比例随之升高,感染程度也越来越严重,建议使用敏感抗菌药物进行抗感染治疗。
[Abstract]:Objective to investigate the effect of bacterial infection on the condition of lower extremity vessels in diabetic foot patients.Methods from June 2015 to August 2016, 88 cases of diabetic foot with bacterial infection were collected and divided into two groups: group A (24 cases), group B (25 cases), group C (20 cases) and group D (19 cases).The general data and laboratory indexes such as ankle brachial index (ABI), toe brachial index (TBI), white blood cell count (WBC) were compared among the four groups, and bacterial culture and drug sensitivity tests were done by collecting the secretion of foot ulcer.Results from group A to group D, the proportion of neutrophils increased gradually, the proportion of neutrophils increased gradually, the proportion of severe infection and the proportion of mixed infection increased gradually, and 195 strains of pathogenic bacteria were detected in bacterial culture.Among them, 102 strains of Gram-negative bacteria accounted for 52.31%, 79 strains of Gram-positive bacteria accounted for 40.51% and 14 strains of fungi accounted for 7.18.The drug sensitivity results showed that the main gram-negative bacteria were sensitive to amikacin, imipenem and other antimicrobial agents.The main gram-positive bacteria were sensitive to Dafopudine and vancomycin.Conclusion the infection of lower extremity is associated with vascular disease in diabetic foot patients. With the development of vascular disease of lower extremity, the proportion of mixed infection increases and the degree of infection becomes more and more serious. It is suggested that sensitive antimicrobial agents should be used for antiinfective therapy.
【作者单位】： 儋州市人民医院内分泌科;海南西部中心医院内分泌科;儋州市人民医院呼吸内科;
【基金】：海南省卫生厅科学研究基金资助项目(1421000320A2004)
【分类号】：R587.2
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本文编号：1714786