糖尿病足患者感染病原体分布及药物敏感性分析

Distribution and drug resistance of pathogens in patients with diabetic foot

目的探讨糖尿病足患者感染病原体分布情况及药物敏感性。方法回顾性分析我院2008年1月至2012年12月收治的65例糖尿病足患者分泌物病原菌培养和药敏试验临床资料。结果 65例患者有48例(73.85%)培养出病原菌,共培养出病原菌72株,其中41株(56.94%)革兰氏阳性菌,28株(38.89%)革兰氏阴性菌,3株(4.17%)真菌;36例患者单一菌感染,12例患者混合菌感染;药敏试验结果提示多药交叉耐药,革兰氏阳性菌对利奈唑胺、替考拉宁、万古霉素、莫西沙星较敏感;革兰氏阴性菌对亚胺培南、莫西沙星较为敏感;真菌对二性霉素B、卡泊芬净最敏感。结论我院糖尿病足伴感染者以革兰氏阳性球菌为主。糖尿病足患者宜及时、多次行分泌物病原检查,合理选择抗菌药物。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with diabetic foot. Methods A retrospective study was carried out on clinical information of patients with diabetic foot from Jan. 2008 to Dec. 2012, types and resistance rates of the pathogens in 65 positive culture secretion of diabetic foot complicating with infection. Results In the infection cases, 48 eases were positive culture （73.85%）. A total of 72 strains of pathogenic bacteria were isolated, including 41 strains of gram positive bacteria （56.94%）, 41 strains of gram-negative bacterium （38.89%）, 41 strains of fungus （4.17%）. There were 46 patients with single microbial infec- tion and 16 patients with polymierobial infection. Gram-positive cocci were sensitive to linezolid, teicoplanin, vaneo- mycin and moxifloxaein. Gram-negative bacilli were sensitive to imipenem and moxifloxaein. Fungi were best sensi- tive to amphotericin B and caspofungin. Conclusion The most common pathogens causing diabetic foot infection are Gram-positive cocci, and pathogens in patients with diabetic foot should be dectected early so as to know the results of distribution and drug resistance of pathogens and hence help the choice of drugs.