糖尿病足合并溃疡感染患者足分泌物病原菌调查、药敏性及相关影响因素分析

Investigation on pathogens of foot secretions in patients with diabetic foot and ulcer infection,drug sensitivity and related influencing factors

目的探讨糖尿病足合并溃疡足分泌物病原菌、药敏性及影响因素。方法选取2018年1月-2019年2月本院就诊糖尿病足患者198例,分析病原菌、药敏性及因素。结果 198例糖尿病足患者中并发溃疡感染63例(31.82%);革兰阴性菌对β-内酰胺酶抑制剂和亚胺培南的抗菌药物敏感性高,大肠埃希菌对常用抗菌药物耐药;白蛋白(Alb)、空腹血糖(FPG)及血红蛋白水平高于无溃疡感染者,高密度脂蛋白胆固醇(HDL-C)水平较低(P <0.05);经Logistic分析,HDL-C、Alb、FPG、血红白蛋白、糖尿病大血管病变、吸烟、糖尿病视网膜病变、溃疡数目> 2个及感染和骨髓炎是糖尿病足并发溃疡感染的危险因素(OR> 1,P <0.05)。结论糖尿病足并发溃疡具有广泛病原菌分布,耐药率高,且糖尿病大血管病变、溃疡数目> 2个、糖尿病视网膜病变等是其发生的危险因素,故需及时采取有效的预防干预措施。

Objective To investigate the pathogen,drug sensitivity and related influencing factors of foot secretions in patients with diabetic foot and ulcer infection.Methods A total of 198 diabetic foot patients were treated in our hospital from January 2018 to February 2019 were enrolled in this study to analyze pathogens,drug susceptibility and factors.Results A total of 63 cases(31.82%)of 198 patients with diabetic foot complicated with ulcer infection;Gram-negative bacteria have high sensitivity toβ-lactamase inhibitors and imipenem antibiotics,and Escherichia coli has resistance to commonly used antibacterial drugs;the levels of albumin(Alb),fasting blood glucose(FPG)and hemoglobin in patients with diabetic foot complicated with ulcer were higher than those without ulcer infection,and the level of high-density lipoprotein cholesterol(HDL-C)was lower(P<0.05);Logistic analysis showed that HDL-C,Alb,FPG,hemoglobin,diabetic macroangiopathy,smoking,diabetic retinopathy,number of ulcers>2 and infection and osteomyelitis are risk factors for diabetic foot complicated with ulcer infection(OR>1,P<0.05).Conclusion Patients with diabetic foot complicated with ulcer infection have a wide distribution of pathogenic bacteria,and have high resistance rate to antibacterial drugs.Diabetic macrovascular disease,number of ulcers>2,and diabetic retinopathy are risk factors,so it is necessary to timely take effective preventive interventions.