糖尿病足耐甲氧西林金黄色葡萄球菌感染的危险因素分析

Risk factors of methicillin-resistant Staphylococcus aureus in diabetic foot infection

目的探讨糖尿病足耐甲氧西林金黄色葡萄球菌(MRSA)感染的危险因素。方法糖尿病足感染(DFI)患者分离的96株金黄色葡萄球菌,用全自动微生物分析仪检测药物敏感性,多因素Logistic回归分析MRSA感染的危险因素。结果MRSA和甲氧西林敏感金黄色葡萄球菌(MSSA)分别占47.9%(46株)和52.1%(50株)。MRSA对头孢西丁、阿米卡星、环丙沙星、左氧氟沙星、克林霉素、红霉素、利福平、四环素的耐药率明显高于MSSA(P<0.01或0.05)。回归分析显示,使用抗生素>1个月、入院前半年内使用抗生素、糖尿病血管并发症和Wagner分级≥3级是DFI患者感染MRSA的独立危险因素。结论DFI患者MRSA感染常见,长期反复使用抗生素、糖尿病血管并发症、高Wagner分级是其危险因素。

Objective To investigate the risk factors of methicillin-resistant Staphylococcus aureus(MRSA)in diabetic foot infection(DFI).Methods Drug susceptibility of 96 isolates of S.aureus from DFI patients was detected by automatic microbiological analyzer,and risk factors of MRSA infection were analyzed by multivariate logistic regression analysis.Results MRSA and methicillin-sensitive S.aureus(MSSA)accounted for 47.9%(46/96)and 52.1%(50/96),respectively.The resistance rates of MRSA against cefoxitin,amikacin,ciprofloxacin,levofloxacin,clindamycin,erythromycin,rifampicin and tetracycline were significantly higher than those of MSSA(P<0.01 or 0.05).Multivariate logistic regression analysis showed that antibiotic use>1 month or within 6 months,diabetic vascular complications,and Wagner grade≥3 were independent risk factors for MRSA in DFI patients.Conclusion MRSA is common in DFI patients.Long-term and repeated use of antibiotics,diabetic vascular complications and high Wagner grading are risk factors for MRSA infection.