糖尿病足感染的病原菌分布及药敏分析

Distribution and antibiotic susceptibility of pathogens isolated from patients with diabetic foot infection

目的:了解我院糖尿病足患者足部溃疡处感染的病原菌分布及药物敏感情况,为抗感染治疗提供临床依据,提高经验性抗感染的疗效。方法:回顾性分析我院2007年8月至2012年4月72例糖尿病足感染患者溃疡处分泌物中分离出的89株病原菌及其药敏结果。结果:89株病原菌中革兰阳性菌和革兰阴性菌各43株,各占48.32%,真菌3株,占3.36%。混合菌感染15例,占20.83%。感染的病原菌以金黄色葡萄球菌、变形杆菌、粪肠球菌和大肠埃希菌为主。药敏结果显示,各种病原菌对常用抗菌药物的耐药率各不相同并有多药交叉耐药现象。革兰阳性球菌对万古霉素、力奈唑烷、左氧氟沙星及利福平较为敏感,革兰阴性菌对亚胺培南、美罗培南、阿米卡星及加β-内酰胺酶抑制剂的抗菌药物较为敏感。结论:糖尿病足感染的病原菌分布广泛,耐药率高,早期选择敏感抗菌药物治疗是糖尿病足感染治疗的关键。

Objective：To study the distribution and antibiotic susceptibility of pathogens isolated from patients with diabetes foot ulcer in our hospital; to provide clinical anti-infection treatment for the basis, improve the curative effect of empirical fight infection. Meth- ods： 89 strains of bacteria isolated from 72 cases of diabetic foot infected patients from August 2007 to April 2012 in our hospital were retrospectively analyzed. Results： In 89 strains of bacteria, there were 43 gram positive coccus, 43 Gram-negative bacteria and 3 fun- gi,accounting for 48.32% ,48.32% and 3.36% of the total number respectively. Polymicrobial infection was identified in 15 patients, accounting for 20. 81%. The main bacteria were staphylococcus aureus,proteus mirabilis,enterocoecus faecalis and E. coli. According to susceptibility test, the antibiotic resistance rates of pathogens varied and multidrug-resistance strains were found. Gram-positive bac- teria were sensitive to vancomycin, linezolid,levofloxacin and nitrofurantoin. Gram-negative bacteria were sensitive to imipenem,mero- penem,amikacin and lactamases inhibitor. Conclusion： The pathogens in diabetic foot infection distribute extensively and some of them are multi-drug resistant. The key to the treatment of diabetic foot infection is early application of sensitive antimicrobial agents.