我院2011年1月-2012年6月糖尿病足感染的病原菌及耐药性分析

Analysis of Common Pathogens of Diabetic Foot Infection and Their Drug Resistance in Our Hospital from Jan.2011 to Jun.2012

目的:分析我院糖尿病足感染的病原菌分类及耐药性,为临床经验性使用抗菌药物提供参考。方法:回顾性分析2011年1月-2012年6月112例就诊于我院的糖尿病足患者的临床资料,着重对糖尿病足合并感染的分泌物阳性培养结果进行病原菌分类及药敏分析。结果:糖尿病足无感染者47例,糖尿病足伴感染者65例;糖尿病足伴感染者病原菌培养阳性54例(83.08%),培养阴性11例(16.92%)。共培养出病原菌72株,主要为金黄色葡萄球菌17株(23.61%)、粪肠球菌10株(13.89%)、大肠埃希菌7株(9.72%)、肺炎克雷伯菌6株(8.33%)、溶血葡萄球菌5株(6.94%)、奇异变形杆菌4株(5.56%)、表皮葡萄球菌3株(4.17%)、铜绿假单胞菌3株(4.17%)。36例为单一菌感染,18例为2种病原菌感染。革兰阳性球菌对莫西沙星、替加环素、利奈唑胺均较敏感,对青霉素、克林霉素、环丙沙星、红霉素交叉耐药,尚未出现对万古霉素耐药的菌株。革兰阴性杆菌对亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢替坦均较敏感,对头孢唑林、氨苄西林、甲氧苄啶/磺胺甲唑交叉耐药。结论:我院糖尿病足伴感染者以革兰阳性球菌为主。主要病原菌对常用抗菌药物的耐药性增高,呈现多重交叉耐药。

OBJECTIVE： To analyze the types and resistance rates of pathogens isolated from patients with diabetic foot infec- tion in our hospital, and to provide reference for antibiotics use in the clinic. METHODS： A retrospective study was carried out on clinical information of patients with diabetic foot in our hospital from Jan. 2011 to Jun. 2012, especially types and resistance rates of the pathogens in 112 positive culture secretion of diabetic foot complicating with infection. RESULTS： There were 65 diabetic foot patients with infections and 47 without. In the infection cases, 54 cases were positive culture （83.08%） and 11 cases negative culture （16.92%）. A total of 72 strains of pathogenic bacteria were isolated, including 17 strains of Staphylococcus aureus （23.61%）, 10 Enterococcus faecalis （13.89%）, 7 Escherichia coli （9.72%）, 6 Klebsiella pneumoniae（8.33% ）, 5 Staphylococ- cus haemolyticus （6.94%）, 4 Proteus mirabilis （5.56%）, 3 Staphylococcus epidermidis （4.17%）, 3 Pseudomonas aeruginosa （4.17%）. There were 36 patients with single microbial infection and 18 patients with polymicrobial infection. Gram-positive cocci were sensitive to moxifloxacin, tigecyclin, linezolid and presented multidrug resistance to penicillin, clindamycin, ciprofloxacin, erythromycin. None of them were resistant to vancomycin. Gram-negative bacilli were sensitive to imipenem, piperacillin/tazobac- tam, amikacin, cefotetan and presented multidrug resistance to cefazolin, ampicillin, trimethoprirn/sulfamethoxazole. CONCLU- SION： The most common pathogens causing diabetic foot infection are Gram-positive cocci. The drug resistance of main pathogens to commonly used antibiotics is increasing, presenting multidrug resistance.