158例糖尿病足病原菌分布与创面特点的关系

Relationship between pathogenic bacterial distribution and wound characteristics in 158 cases of diabetic foot

目的分析糖尿病足住院患者创面的病原菌分布、药敏情况及其与创面特点之间的关系。方法选取2017年1月至2019年12月该院急诊外科糖尿病足住院患者158例作为观察对象,取足部创面深部组织,行微生物培养及药敏试验。结果糖尿病足患者Wagner2、3级创面革兰阳性菌菌株(2级22株,3级30株)多于革兰阴性菌菌株及真菌,Wagner4级创面革兰阴性菌菌株(44株)多于革兰阳性菌菌株及真菌,Wagner 5级共培养细菌2株均为革兰阴性菌。革兰阳性菌对万古霉素、替考拉林、利奈唑胺、替甲环素的敏感度为100%,革兰阴性菌对亚胺培南、美罗培南、庆大霉素、氨基糖苷类的敏感度较高。结论糖尿病足患者创面病原菌以革兰阳性菌为主,糖尿病足Wagner分级越高,革兰阴性细菌、真菌感染率逐渐升高。

Objective To analyze the distribution of pathogenic bacteria,drug sensitivity and their relationship with wound characteristics in the inpatients with diabetic foot.Methods A totals of 158 inpatients with diabetic foot in the emergency surgery department of this hospital from January 2017 to December 2019 were selected as the observation subjects.The deep tissue of foot wound was taken for conducting the microbial culture and drug sensitivity test.Results Gram-positive bacteria strains in the diabetic foot patients with Wagner grade 2 and 3 wounds were more than Gram-negative bacteria strains and fungi(22 strains in grade 2 and 30 strains in grade 3),while Gram-negative bacteria strains(44 strains)in the patients with Wagner grade 4 wounds were more than Gram-positive bacteria and fungi.Two strains of bacteria in the patients with Wagner grade 5 all were Gram negative bacteria.The sensitivity of Gram-positive bacteria to vancomycin,teicoplanin,linezolid and tigecycline was 100%.The sensitivity of Gram-negative bacteria to imipenem,meropenem,gentamicin and aminoglycosides was high.Conclusion The wound pathogenic bacteria are mainly Gram positive bacteria.The higher the Wagner grade of diabetic foot,the infection rate of Gram negative bacteria and fungi is gradually increased.