糖尿病足患者多药耐药菌感染的危险因素分析

Risk factors for multidrug-resistant bacteria infections in diabetic foot patients

目的研究糖尿病足患者多药耐药菌发生原因,分析多药耐药菌感染的危险因素,以降低多药耐药菌感染。方法对2010年5月-2013年5月医院内分泌科与骨科收治的160例糖尿病足感染患者送检标本进行培养,并对检出病原菌及其药敏结果进行分析;研究糖尿病足患者多药耐药菌感染的危险因素。结果 160例糖尿病足感染患者中有51例发生多药耐药菌感染,占31.8%,分离出75株多药耐药菌,其中金黄色葡萄球菌、铜绿假单胞菌及肠杆菌科高居前3位,分别占40.0%、25.4%及24.0%;通过多因素logistics回归分析显示,既往的抗菌药物暴露史、暴露时间、因同一处部位感染住院>2次/年、合并骨髓炎以及神经缺血性伤口等是发生多药耐药菌感染危险因素。结论糖尿病足患者发生多药耐药菌感染与多种因素有密切的关系,临床医师应该采取相应措施加以控制。

OBJECTIVE To explore the causes of multidrug-resistant bacteria infections in the patients with diabetic foot and analyze the risk factors for the multidrug-resistant bacteria infections so as to reduce the incidence of multidrug-resistant bacteria infections .METHODS A total of 160 patients with diabetic foot infections who were treated in the department of endocrinology and department of orthopedics from May 2010 to May 2013 were enrolled in the study ,then the submitted specimens were cultured for the isolation of pathogens ,the results of the drug susceptibility testing for the isolated pathogens were analyzed ,and the risk factors for the multidrug-resistant bacteria infections in the diabetic foot patients were observed .RESULTS Of the 160 patients with diabetic foot ,51 cases were infected with the multidrug-resistant bacteria ,accounting for 31 .8% .Totally 75 strains of multidrug-resistant bacteria have been isolated ,among which the Staphylococcus aureus ,Pseudomonas aeruginosa ,and En-terobacteriaceae ranked the top three species ,accounting for 40 .0% ,25 .4% ,and 24 .0% ,respectively .The multivariate logistic regression analysis indicated that the history of exposure to antibiotics ,time of exposure , frequency of hospitalization more than twice a year due to the same site infections ,complication of osteomyelitis , and neurological ischemic wounds were the risk factors for the multidrug-resistant bacteria infections . CONCLUSIONS The incidence of the multidrug-resistant bacteria infections in the diabetic foot patients is closely related to multiple factors ,and the clinicians should take corresponding control measures .