摘要
目的分析不同级别糖尿病足感染患者病原菌分布并对主要病原菌进行耐药性分析,为临床经验性抗感染治疗提供依据。方法选取本地区糖尿病足感染患者作为研究对象,依据感染程度将其分为轻度、中度及重度感染组,采集糖尿病足患者病损边缘深部组织,进行病原菌鉴定及药敏试验。结果共收集糖尿病足感染患者标本92例,其中1例标本培养为阴性,其余均为阳性。不同级别糖尿病足感染患者革兰阳性菌与革兰阴性菌分布差异有统计学意义(χ~2=15.543,P<0.05),其中轻度感染组以革兰阳性菌(73.5%)感染为主,主要为金黄色葡萄球菌,药敏试验对万古霉素、利奈唑胺、庆大霉素及米诺环素比较敏感;中度感染组以革兰阴性菌感染为主(59.4%),主要为大肠埃希菌、铜绿假单胞菌、液化沙雷菌,药敏试验对亚胺培南、阿米卡星、头孢吡肟较为敏感;重度感染组以革兰阴性菌感染为主(61.8%),主要为阴沟肠杆菌、鲍曼不动杆菌、弗氏柠檬酸杆菌,药敏试验对亚胺培南、阿米卡星、头孢吡肟较为敏感。结论不同级别糖尿病足感染患者病原菌分布不同,在感染初期依据患者感染程度分级,针对相应的主要致病菌经验性选择相应的抗生素进行治疗,对提高患者治愈率、改善生存质量具有重要的临床意义。
Objective To analyze the distribution of pathogenic bacteria in patients with different grades diabetic foot infection and the drug resistance of major pathogens,so as to provide the evidence for clinical empirical anti-infective treatment.Methods Patients with diabetic foot infection in this area were selected as the research subjects.According to the garades of infection,they were divided into light,moderate and severe infection groups.The deep tissues of the lesions of diabetic foot patients were collected for pathogen identification and drug susceptibility test.Results A total of 92 specimens of patients with diabetic foot infection were collected.One of the specimens was negative and the others were positive.There were differences in the distribution of Gram-positive and Gram-negative bacteria in patients with different grades of diabetic foot infection,and the difference was statistically significant(χ^2=15.543,P<0.05),Among them,The mild infection group was mainly infected with Gram-positive bacteria(73.5%),mainly Staphylococcus aureus,and the drug sensitivity test was sensitive to vancomycin,linezolid,gentamicin and minocycline;In the moderate infection group,Gram-negative bacteria were the main infection(59.4%),mainly Escherichia coli,Pseudomonas aeruginosa and Serratia liquefaciens,the drug sensitivity test was sensitive to imipenem,amikacin and cefepime;In the severe infection group,Gram-negative bacteria were the main infection(61.8%),mainly Enterobacter cloacae,Acinetobacter baumannii,Citrobacter freundii,and the drug susceptibility test was sensitive to imipenem,amikacin and cefepime.Conclusion The distribution of pathogens in patients with different grades diabetic foot infection is different.According to the grade of infection of patients at the initial stage of infection,it is important to select the corresponding antibiotics for the corresponding main pathogens.It has important clinical significance for improving the cure rate and improving the quality of life.
作者
曹蕾
孙学慧
王晓军
陈玲玲
余晓凤
冯军
CAO Lei;SUN Xue-hui;WANG Xiao-jun(The Second Clinical College of Chengde Medical University , Clientele Central Hospital Laboratory ,Chengde 067000,China)
出处
《中国实验诊断学》
2019年第3期395-398,共4页
Chinese Journal of Laboratory Diagnosis
关键词
糖尿病足
感染
病原菌
耐药性
diabetic foot
infection
pathogen
drug resistance
作者简介
通讯作者:冯军.
