摘要
目的探讨不同Wagner分级的糖尿病足感染患者病原菌分布及耐药性。方法选取河南省人民医院2017年1月至2019年8月收治的210例糖尿病足组织培养阳性的住院患者为研究对象,采用SPSS22.0及WHONET5.6对数据进行处理和分析。结果210例糖尿病足感染患者中,Wagner分级2级60例(28.6%),3级65例(31.0%),4级83例(39.5%),5级2例(0.9%)。2级、3级、4级糖尿病足感染患者共208例,占99.0%。检出病原菌285株。其中革兰阳性菌135株(47.7%),以金黄色葡萄球菌为主(70株,51.9%);革兰阴性菌141株(49.8%),以变形杆菌属为主(30株,21.3%);真菌7株(2.5%);有58例(27.6%)患者存在混合感染。随着Wagner分级的增加,金黄色葡萄球菌检出率逐渐降低,变形杆菌属检出率逐渐增加,差异有统计学意义(P<0.05)。耐甲氧西林的金黄色葡萄球菌检出率在29.3%~40.0%,未发现万古霉素、替考拉宁、利奈唑胺及奎奴普丁/达福普汀耐药菌株。对变形杆菌属敏感率较高的药物有亚胺培南、美罗培南、哌拉西林/他唑巴坦。结论糖尿病足感染患者以Wagner分级2级、3级、4级为主,主要病原菌为金黄色葡萄球菌、变形杆菌属。临床可根据不同Wagner分级,选择经验用药。
Objective To investigate the distribution and drug resistance of pathogenic bacteria in patients with diabetic foot infection with different Wagner grades.Methods A tatol of 210 patients with tissue culture-positive diabetic foot infection from January 2017 to August 2019 in Henan Provincial People′s Hospital were retrospectively analyzed.SPSS22.0 and WHONET5.6 were used to process and analyze the data.Results Among the 210 patients with diabetic foot infection,60 cases(28.6%)were grade 2,65 cases(31.0%)were grade 3,83 cases(39.5%)were grade 4,and 2 cases(0.9%)were grade 5.There were 208 patients with grade 2,3 and 4 diabetic foot infection,accounting for 99.0%,and 285 strains of pathogenic bacteria were detected.Among them,135 strains(47.7%)of Gram-positive bacteria were found,and Staphylococcus aureus was the main strain(70 strains,51.9%);141 strains(49.8%)of Gram-negative bacteria were found,and Proteus was the main strain(30 strains,21.3%);7 strains of fungi(2.5%);there were 58 patients(27.6%)with mixed infection.With the increase of Wagner grade,the detection rate of Staphylococcus aureus gradually decreased,and the detection rate of Proteus gradually increased,the difference was statistically significant(P<0.05).The detection rate of methicillin-resistant Staphylococcus aureus was 29.3%to 40.0%,and no vancomycin,teicoplanin,linezolid and quinuptine/dafutin resistant strains were found.The drugs with higher sensitivity rate of Proteus were imipenem,meropenem,piperacillin/tazobactam.Conclusion The patients with diabetic foot infection are mainly Wagner grade 2,3 and 4,and the main pathogens are Staphylococcus aureus and Proteus.In clinical practice,empirical medication can be selected according to different Wagner classifications.
作者
马冰
高丽
李晶
王山梅
闫文娟
袁有华
李轶
MA Bing;GAO Li;LI Jing;WANG Shanmei;YAN Wenjuan;YUAN Youhua;LI Yi(Department of Clinical Laboratory,Henan Provincial People′s Hospital,Zhengzhou,Henan 450003,China;Department of Clinical Laboratory,Huaxian Hospital of Traditional Chinese Medicine,Anyang,Henan 456400,China;Department of Clinical Laboratory,Pingyu County Central Hospital,Zhumadian,Henan 463003,China)
出处
《检验医学与临床》
CAS
2022年第17期2344-2348,共5页
Laboratory Medicine and Clinic
基金
河南省医学科技攻关计划项目(202102310355)。
关键词
糖尿病足
Wagner分级
感染
病原菌
diabetic foot
Wagner classification
infection
pathogenic bacteria
作者简介
马冰,女,主管技师,主要从事革兰阳性菌耐药机制相关研究;通信作者:李轶,E-mail:liyilabmed@henu.edu.cn。
