糖尿病足患者创面病原菌分布及耐药性变迁

Change of pathogen distribution and drug resistance in patients with diabetic foot

目的了解广东地区糖尿病足患者创面病原菌分布及耐药性变迁。方法回顾性分析A组(2010年1月—2014年12月就诊的糖尿病足患者)和B组(2015年1月—2018年1月就诊的糖尿病足患者)研究者创面病原菌分布及耐药性变迁。结果 B组中创面G+菌及G-菌均有下降趋势且G-菌下降较快,细菌种类明显增加,真菌及混合感染明显上升,A组以金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌感染为主; B组以金黄色葡萄球菌、奇异变形杆菌、铜绿假单胞菌及真菌感染为主; B组相对于A组的细菌耐药性增加。结论近年来糖尿病足患者病原菌种类明显增加且混合感染及真菌感染上升,且其耐药性增加,因此早期经验用药而后根据药敏选择抗菌药物治疗是糖尿病足感染治疗的关键。

Objective To investigate the distribution and drug resistance of pathogenic bacteria in diabetic foot wounds in Guangdong area. Methods Patients with diagnosis of diabetic foot between group A （from Jan 2010 - Dec 2014 ） and group B （from Jan 2015 to Jan 2018 ） were retrospectively analyzed. We studied the bacteria distribution and drug resistance of pathogenic changes of group A and group B. Results In group B, both G ＋ and G- bacteria had a decreased trend while G- bacteria decreased rapidly, but the species of bacteria increased obviously just as fungi and mixed infection increased obviously. Bacteria infection in group A were mainly about Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli wihle group B were Staphylococcus aureus, Proteus mirabilis, Aeruginsa and Fungal infection ; the resistance of group B to A was lower. Conclusion In recent years, kinds of pathogenic bacteria of diabetic foot were significantly increased and the mixed infeetion and increased fungal infeetion as well as its drug resistance increased, so the early experience of medication choice of antibiotics based on drug sensitivity and treatment are the key to the treatment of diabetic foot infeetion.