193例糖尿病足感染患者病原学特点及用药情况分析

Analysis of the pathogens and medication in 193 patients with diabetic foot

目的分析糖尿病足(DF)患者病原学及相关用药情况。方法选取2016年1月至2017年2月于西安交通大学第一附属医院内分泌科住院的193例DF患者,分析其高危因素、病原菌及用药情况等。结果 193例DF患者中男134例,占69.43%,女59例,占30.57%。110例有明确的病原学结果,共培养出178种致病菌。Logistic回归分析显示,DF的严重程度与性别(t=5.763,P=0.016)及中性粒细胞百分比(t=7.968,P=0.005)相关。DF患者感染常见混合性细菌感染,革兰氏阴性菌占比例较高,病原菌检出前3位分别是金黄色葡萄球菌(20.23%)、铜绿假单胞菌(9.55%)和阴沟肠杆菌(6.75%),且耐药菌所占比例较高。抗菌药物的使用以β-内酰胺抗菌药物为主,达45.48%。结论临床上在治疗DF感染时,应做好细菌学鉴定,从而指导临床抗菌药物的合理使用。

Objective To analyze the clinical features,pathogens and antibiotic treatment of patients with diabetic foot（DF）. Methods 193 DF patients who were admitted to the First Affiliated Hospital of Xi＇an Jiaotong University from Jan 2016 to Feb 2017 were included in this study to analyze the risk factors,pathogens and medications. Results There were 134 males,59 famales,accounting for 69.43%and 30.57%.178 different pathogens were identified in 110 patients.Multivariate logistic analysis showed that the severity of DF was correlated with gender（t=5.763,t=0.016）and the percentage of neutrophils（t=7.968,P=0.005）.Most DF infections were mixed bacterial infection,with a higher proportion of gram-negative.The top three pathogenic bacteria were staphylococcus aureus（20.23%）,pseudomonas aeruginosa（9.55%）and enterobacter vaginae（6.75%）,and the proportion of drug-resistant bacteria was higher.β-lactamide antimicrobials were frequently used（45.48%）. Conclusion In the treatment of DF infection,bacteriological identification should be done to guide the rational use of antibacterials.