糖尿病足溃疡患者创面病原菌分布及耐药性分析

Distribution and drug resistance of pathogens of wound in patients with diabetic foot ulcer

目的采集糖尿病足溃疡患者创面分泌物进行细菌培养及药敏试验,分析其创面病原菌分布特征及耐药性.方法回顾性分析本院收治的90例糖尿病足溃疡患者临床资料,采集所有患者创面分泌物样本,并进行病原菌培养分离及药敏试验,分析糖尿病足溃疡患者创面病原菌分布特征及其对各类抗菌药物的耐药性.结果90例糖尿病足溃疡患者创面分泌物中共分离出128株病原菌,其中革兰阳性菌65株,以粪肠球菌、金黄色葡萄球菌为主;革兰阴性菌63株,以大肠埃希菌、奇异变形杆菌为主;粪肠球菌对苯唑西林、红霉素的耐药率最高,对莫西沙星、利奈唑胺的耐药率最低;金黄色葡萄球菌对利福平、庆大霉素、四环素、利奈唑胺的耐药率最高,对莫西沙星、克林霉素耐药率最低;大肠埃希菌对氨苄西林/舒巴坦、头孢曲松的耐药率最高,对庆大霉素、阿米卡星、亚胺培南、哌拉西林/他唑巴坦的耐药率最低;奇异变形杆菌对氨曲南、亚胺培南的耐药率最高,对阿米卡星的耐药率最低.结论糖尿病足溃疡患者创面病原菌种类较多,临床上应依据病原菌分布特征及药敏试验结果选择抗菌药物,以提高治疗效果.

Objective To eolleet the secretion of wound in patients with diabetic foot uleer and carry oul bacterial culture and drug sensitivity lest,to analyze its distribution c haracteristices and drug resistance of pathogens of wound.Methods A retrospective analysis was performed,the clinical data of 90 patients with diabetie foot uler treated in our hospital from October 2018 to October 2020 were colleeted,samples of wound secretion of all patients were ollected,and the culture and isolation of pathogens and drug sensitivity test were earried outl.the distribution characteristics of wound pathogens in patients with diabetic foot ulcer and their drug resistance to various antibacterial drugs were analyzed.Results 128 pathogens were isolated from the wound seeretion of 90 patients with diabetie fool uleer,of which 65 were Gram-positive bacteria.mainly were Enterococcus faecalis and Slaphylococcus aureus;63 were Gram-negative bacteria,mainly were Escherichia coli and Proteus singular;the drug resistance rate of Enterncceus faecalis to benzoxacillin and erythromyein was the highest,and that of moxifloxacin and linazolamide was the lowest;the drug resistance rate of Staphy lococeus aureus to rifampin,gentamicin,tetracyeline and linazolamide was the highesl,and the drug resistance rate to mosiloxaein and elindamyein was the lowest:the drug resistance rate of Escherichia coli to ampilin 1 sulbactam and ceftriaxone was the highest,while that of gentamicin,amikacin,imipenem and piperaillin 1 lazobactam was the lowesl;the drug resistance rale of Proleus singular to aminotrian and imipenem was the highest,and the resistance rate to amikacin was the lowest.Conclus ion There are many kinds of wound pathogens in patients with diabetic foot ulcer,antibacterial drugs should be selected according to the distribution characleristies of pathogens and drug sensitivily lest resuls in elinie,in order to improve the lreatment efeet.