糖尿病足感染患者的病原菌分布及药敏分析

Distribution and drug susceptibility of pathogens causing diabetic foot infections

目的研究糖尿病足溃疡感染病原菌分布,并对其临床耐药性进行相关分析,为临床预防治疗提供参考依据。方法对2011年5月-2013年5月在医院就诊的178例糖尿病足溃疡感染患者的溃疡物或脓性分泌物,进行病原菌培养及药敏分析,病原菌培养严格按照临床操作流程逐步进行,药敏试验采用纸片扩散法进行,采用SPSS 13.0统计软件对数据进行处理。结果 178例患者共分离出病原菌214株,其中革兰阴性菌124株占57.9%,革兰阳性菌65株占30.4%,真菌25株占11.7%;病原菌排名前5位的分别为大肠埃希菌、普通变形菌、金黄色葡萄球菌、类肠球菌、肺炎克雷伯菌,分别占15.4%、9.8%、8.9%、8.4%、6.1%;革兰阴性菌对哌拉西林、阿米卡星以及头孢拉定较为敏感,敏感率>75.0%;革兰阳性菌对万古霉素以及庆大霉素较为敏感,敏感率>85.0%;真菌对氟康唑以及伏立康唑较为敏感,敏感率>81.5%。结论在临床治疗过程中,可以根据药敏试验结果及时调整抗菌药物,以促进溃疡早期愈合。

OBJECTIVE To study the distribution of pathogenic bacteria causing diabetic foot ulcers and analyze the drug resistance so as to provide guidance for the clinical prevention and treatment. METHODS A total of 178 cases of diabetic foot ulcers, who were treated in the hospital from May 2011 to May 2013, were enrolled in the study, then the ulcers or purulent secretions were collected for culture of pathogens, the drug susceptibility testing was performed with the use of disk diffusion method, the culture of pathogens was conducted by strictly according to the clinical operation procedures, and the statistical analysis was performed with the use of SPSS13.0 software. RESULTS Totally 214 strains of pathogens have been isolated from the 178 patients, including 124 （57. 9~） strains of gram-negative bacteria, 65 （30.4 ~） strains of gram-positive bacteria, and 25 （11.7 ~/00 ） strains of fungi; the Escherichia coli, Proteus vulgaris, Staphylococcus aureus, Enterococcus, and Klebsiella pneumoniae ranked the top five species of pathogens, accounting for 15.4~, 9.8~, 8.9~, 8.4%, and 6.1~, respectively. The gram-negative bacteria were highly susceptible to piperacillin, amikacin, and cefradine, with the drug susceptibility rate more than 75. 0~; the gram-positive bacteria were highly susceptible to vancomycin and gentamicin, with the drug susceptibility rate more than 85.0% ; the fungi were highly susceptible to fluconazole and voriconazole, with the drug susceptibility rate more than 81.5 ~. CONCLUSION The use of antibiotics should be adjusted in a timely manner according to the result of drug susceptibility testing during the clinical treatment so as to promote the early healing of ulcers.