院前糖尿病足患者溃疡分泌物细菌培养与药敏分析

Culture of bacteria isolated from ulcerous secretion of diabetic foot patients and drug sensitivity test

目的了解粤西地区糖尿病足患者院前感染病原菌分布及药敏情况。方法选择在我院门诊或住院入选的120例糖尿病足患者,在门诊或入院当天取其溃疡处分泌物按操作规程作细菌培养、鉴定和药敏试验。结果共分离出182株细菌,其中革兰阴性菌91株(50.0%)、革兰阳性菌76株(41.8%)和真菌15株(8.2%)。检出革兰阴性菌各菌种占比率分别为大肠埃希菌15.93%、铜绿假单胞菌10.99%、肺炎克雷伯菌肺炎亚种10.44%、变形菌属7.14%、阴沟肠杆菌5.50%,亚胺培南、美洛培南对革兰阴性菌抗菌活性较高,对其它常用抗菌药物有不同程度的耐药;革兰阳性菌各菌种占比率分别为金黄色葡萄球菌17.58%、表皮葡萄球菌6.59%、肠球菌属6.04%、其它球菌属11.55%,未见对万古霉素耐药的革兰阳性菌。结论糖尿病足溃疡感染的病原菌以革兰阴性菌居多,耐药情况严峻,应重视对院前糖尿病足感染者进行病原菌及其药敏检测,以为其防治提供依据。

Objective To investigate the distribution and the drug resistance of pathogens from prehospital patients with diabetic foot ulcers in west Guangdong Province. Methods The secretion from the ulcer area of 120 prehospital patients with diabetic foot ulcers was obtained and the secretion bacterial culture was performed. The pathogenic bacteria were isolated, identified and the drug tolerance were characterized. Results Among the 182 strains of germs were isolated from the culti-vation of 120 subjects＇ secretion from the ulcer area, 91 of them were Gram - negative bacteria（50.0% ）, Gram - positive cocci were 76 （41.8%） and fungus 15 （8.2%）. Anterior of 91 strains of gram -negative bacteria were Escherichia coli （15. 93% ）, Pseadomonas aeruginosa（ 10.99% ）, Klebsiella pneumoniae（ 10.44% ）. The sensitive rates of 91 strains olny to Im- penem and Meropenem were high; Anterior of 76 strains of Gram - positive cocci were staphylococcus aureus （ 17.58% ）, acinetobacter（6.59% ）, enterococcus（6.04% ） and other strains（ 11.55% ）. The sensitive rates of 76 strains olny to vanco- mycin were high. Conclusion The most prevalent pathogenic bacteria of prehospital patients with diabetic foot ulcers remained to be Gram negative bacteria, which exhibited high drug resistance. We should pay attention to both pathogenic bacteria culture and drug sensitive test so as to provide evidence for treatment of diabetic foot ulcers.