某院83例糖尿病足感染患者的病原菌分布及其对抗菌药物的敏感性分析

Analysis on Distribution of Pathogenic Bacteria in 83 Patients with Diabetic Foot Infection in a Hospital and Their Sensitivity to Antimicrobial Agents

目的:探究糖尿病足感染患者的病原菌分布特点,分析病原菌对不同抗菌药物的耐药性。方法:选取医院2019年1月—12月间收治的糖尿病足溃疡感染伴微生物培养阳性患者83例病历资料,统计与分析其病原菌的分布特点及其对抗菌药物的耐药情况。结果:83例糖尿病足感染患者分泌物中,培养出108株病原菌,其中革兰阳性菌45株、革兰阴性菌61株和真菌2株;革兰阳性菌对利奈唑胺、万古霉素较敏感,而对红霉素、克林霉素的敏感性较差;MRSA占金黄色葡萄球菌的24.00%,MRSE占表皮葡萄球菌的66.67%;主要革兰阴性菌对美罗培南、哌拉西林-他唑巴坦钠、阿米卡星的敏感率较高,而其对氨苄西林、头孢唑林的敏感率较低,其中肺炎克雷伯菌产ESBLs占25.00%、大肠埃希菌产ESBLs占71.43%;近平滑假丝酵母和热带假丝酵母对现用抗真菌药物的敏感率均达100.00%。结论:糖尿病足感染患者分泌物中病原菌分布较为复杂,不同病原菌对抗菌药物的敏感率相差较大,临床应根据药敏试验结果合理选用抗菌药物治疗。

Objective:To explore the distribution characteristics of pathogenic bacteria in patients with diabetic foot infection and to analyze the resistance of pathogenic bacteria to different antibacterial drugs.Methods:The medical records of 83 patients with diabetic foot ulcer infection and positive microbial culture admitted to the hospital from January to December 2019 were selected,and the distribution characteristics of pathogenic bacteria and their resistance to antimicrobial agents were statistically analyzed.Results:108 strains of pathogenic bacteria were cultured from the secretions of 83 patients with diabetic foot infection,including 45 strains of Gram-positive bacteria,61 strains of Gramnegative bacteria and 2 strains of fungi.Gram-positive bacteria were more sensitive to linezolid and vancomycin,but less sensitive to erythromycin and clindamycin.MRSA accounted for 24.00%of S.aureus,and MRSE for 66.67%of S.epidermis.The main Gram-negative bacteria showed higher sensitivity to meropenem,piperacillin-tazobactam and amikacin,while their sensitivity to ampicillin and cefazolin was relatively poor.Among them,ESBLs of Klebsiella pneumoniae and Escherichia coli accounted for 25.00%and 71.43%respectively.The sensitivity of Candida parapsilosis and Candida tropicalis to anti-fungal agents was 100.00%.Conclusion:The distribution of pathogenic bacteria in the secretions of patients with diabetic foot infection is relatively complex,and the sensitivity rates of different pathogenic bacteria to antibacterial drugs vary greatly.Therefore,antimicrobial therapy should be rationally selected based on the results of drug sensitivity test in clinical practice.