糖尿病足患者多药耐药菌谱变迁的危险因素分析

Analysis of multi-resistant bacteria spectrum change and related patients

目的 分析糖尿病足患者多药耐药菌（MDROs）的分布、耐药性及危险因素。 方法 收集糖尿病足感染患者100例，根据是否发生MDROs分为实验组与对照组，每组50例。取两组患者的分泌物行病原菌检测及药敏试验，对两组患者感染的病原菌分布进行统计；比较两组患者抗菌药物的耐药情况；分析影响糖尿病足患者MDROs的危险因素。 结果 糖尿病足感染患者的MDROs的分布前3位为金黄色葡萄球菌、肠杆菌、铜绿假单胞菌。金黄色葡萄球菌对多种抗菌药物耐药，但对万古霉素敏感（P〈0.05）。铜绿假单胞菌、肠杆菌科细菌对亚胺培南耐药率最低（P〈0.05）。未发生感染时使用抗生素、骨髓炎、神经缺血性切口，是糖尿病足患者发生MDROs的危险因素（P〈0.05）。 结论 糖尿病足MDROs中金黄色葡萄球菌对万古霉素敏感，而铜绿假单胞菌及肠杆菌对亚胺培南相对敏感。未发生感染时使用抗生素、骨髓炎、神经缺血性切口，是糖尿病足患者发生MDROs的危险因素。

Objective To analyze the multi-resistant bacteria （MDROs） distribution, drug resistance and risk factors of diabetic foot patients. were selected, secretions of patients in two groups Methods The patients with diabetic foot infection were took for pathogen detection and drug sensitive test, and the pathogenic bacteria distribution was analyzed; the antimicrobial resistance was compared be- tween the two groups; the risk factors of MDROs in diabetic foot patients were analyzed. Results The first three distribution of MOROs in patients with diabetic foot infection was Staphylococcus aureus, E. coli, Pseudomonas aeruginosa. Staphylococcus aureus was resistant to many kinds of antimicrobial agents, but sensitive to vancomycin （ P 〈 0. 05 ） ; the resistance rate of Pseudomonas aeruginosa and En- terobacteriaceae to imipenem was lowest （ P 〈 0. 05 ） ; the use of antibiotics without infection, osteomyeli- tis, and neurological ischemic injuries were risk factors for MDROs in diabetic foot patients （P 〈 0. 05 ）. Conclusions Among MOROs in the diabetic foot patients, Staphylococcus aureus is sensitive to vanco- mycin, while Pseudomonas aeruginosa and Enterobacter are relatively sensitive to imipenem. Utilizations of antibiotics without infection, osteomyelitis, neurological ischemic wounds are risk factors for diabetic foot patients with MDROs.