不同Wagner分级糖尿病足感染患者溃疡病原菌的特点、药敏性及炎性指标变化的研究

Study on Characteristics, Drug Sensitivity and Changes of Inflammatory Indicators of Ulcerative Pathogens in Patients with Different Wagner Grades of Diabetic Foot Infection

目的探讨不同Wagner分级糖尿病足感染患者溃疡病原菌的特点、药敏性及炎性指标变化。方法 96例糖尿病合并糖尿病足感染患者,根据Wagner分级分为1级(30例)、 2级(33例)、 3级(23例),分析溃疡病原菌的特点、药敏性及炎性指标。结果 Wagner 1级患者感染多为革兰阳性菌, Wagner 2级患者感染多为革兰阴性菌, Wagner 3级患者感染多为革兰阴性菌。革兰阴性菌主要对泰能、阿米卡星、哌拉西林较为敏感,大多对头孢唑林、氨苄西林耐药;革兰阳性菌主要对庆大霉素、替考拉宁、莫西沙星较为敏感,大多对青霉素、大环内酯类耐药。在炎性指标hs-CRP、 Hb A1c、 PCT水平上, Wagner 3级>Wagner 2级>Wagner 1级,差异有统计学意义(P <0.05)。结论糖尿病足感染患者Wagner等级越高,革兰阴性菌占比越高,加强对炎性指标的检测可为疾病的缓解和康复提供参考。

Objective To explore the characteristics, drug sensitivity and changes of inflammatory indicators of ulcerative pathogens in patients with different Wagner grades of diabetic foot infection. Methods 96 patients with diabetes mellitus complicated with diabetic foot infection were classified into grade 1(30 cases), grade 2(33 cases) and grade 3(23 cases) according to Wagner classification. The characteristics, drug sensitivity and inflammatory indicators of ulcerative pathogens were analyzed. Results Gram-positive bacteria were mostly found in Wagner grade 1 patients, Gram-negative bacteria in Wagner grade 2 patients and Gram-negative bacteria in Wagner grade 3 patients. Gram-negative bacteria were mainly sensitive to tienam, amikacin and piperacillin, and most of them were resistant to cefazolin and ampicillin. Gram-positive bacteria were mainly sensitive to gentamicin, teicoplanin and moxifloxacin, and most of them were resistant to penicillin and macrolides. In inflammatory indicators of hs-CRP, HbA1 c and PCT, Wagner grade 3 > Wagner grade 2 > Wagner grade 1,with statistical difference(P<0.05). Conclusions The higher the Wagner grade of diabetic foot infection patients, the higher the rate of Gram-negative bacteria. Strengthening the detection of inflammatory indicators can provide reference for relief and rehabilitation of disease.