糖尿病足感染病原菌特点分析

Pathogenic bacteria causing infections in diabetic foot patients

目的探讨糖尿病足感染患者的病原菌分布及药物敏感性特点,为临床合理选择抗菌药物提供依据。方法选择2011年1月-2013年1月医院收治的糖尿病足感染患者113例,回顾性分析患者的临床资料,分析患者足分泌物的病原菌培养结果及药敏资料。结果 113例患者共采集137份合格标本,培养出病原菌109株,其中革兰阴性菌56株占51.38%,革兰阳性菌42株占38.53%,真菌11株占10.09%;革兰阴性菌对碳青霉烯类抗菌药物和莫西沙星敏感性相对较高;革兰阳性菌对糖肽类抗菌药物、碳青霉烯类抗菌药物、莫西沙星敏感性相对较高;真菌则对两性霉素B和卡泊芬净敏感度最高。结论对于糖尿病足感染患者要及早并多次进行分泌物的病原菌检测,指导进行临床筛选敏感抗菌药物的使用,减少耐药菌的产生。

OBJECTIVE To explore the distribution of pathogenic bacteria causing infections in the diabetic foot patients and analyze the drug susceptibility so as to provide guidance for reasonable clinical use of antibiotics. METHODS A total of 113 cases of diabetic foot with infections who were treated in the hospital were enrolled in the study,then the clinical data were retrospectively analyzed,the result of bacterial culture of foot secretions was analyzed,and the data of drug susceptibility testing were observed.RESULTS Totally 137 samples obtained from the 113 patients were eligible,from which 109 strains of pathogens have been isolated,including 56（51.38%） strains of gram-negative bacteria,42（38.53%）strains of gram-positive bacteria,and 11（10.09%）strains of fungi.The gram-negative bacteria were relatively susceptible to carbapenems and moxifloxacin;the gram-positive bacteria were highly susceptible to glycopeptide antibiotics,carbapenem antibiotics,and moxifloxacin;the drug susceptibility rates of the fungi to amphotericin B and caspofungin were the highest.CONCLUSIONFor the diabetic foot patients with infections,the culture of secretions should be performed in a timely manner for the isolation of pathogens,and the antibiotics should be reasonably used based on the result of drug susceptibility testing so as to reduce the drug-resistant strains.