糖尿病足骨髓炎的病原菌分布与耐药性分析

Bacterial distribution and resistance in diabetic foot osteomyelitis

目的分析糖尿病足骨髓炎(DFO)的病原菌分布及耐药特征。方法收集2016至2019年北京大学第一医院住院DFO患者的感染标本,常规方法进行细菌培养和鉴定,按纸片法、微量稀释法或E-test法测定细菌药物敏感率。结果在纳入的72例患者中,共分离出非重复细菌99株,其中革兰阳性菌53株,革兰阴性菌46株。金黄色葡萄球菌与粪肠球菌分别占18.2%和13.1%,对万古霉素、利奈唑胺和替加环素敏感率均为100%;铜绿假单胞菌和大肠埃希菌分别占13.1%和9.1%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南和美罗培南等敏感率较高。结论革兰阳性菌,特别是金黄色葡萄球菌,是DFO的主要病原菌。

Objective To investigate the bacterial distribution and resistance to antibiotic in diabetic foot osteomyelitis(DFO).Methods All the stains of inpatients were isolated from infectious tissue from 2016 to 2019.The stains were cultured and identified by conventional method,and their susceptibility were tested by disk diffusion,microbroth dilution or E-test according to Clinical and Laboratory Standard Institute(CLSI,2018)manual.Results A total of 99 strains were collected from 72 patients in 4 years.There were 53 strains of Gram-positive bacteria and 46 strains of Gram-negative bacteria.Staphylococcus aureus and Enterococcus faecalis were the main Gram-positive bacteria,accounting for 18.2%and 13.1%,which were 100%sensitive to vancomycin,linezolid and tigecycline;while Pseudomonas aeruginosa and Escherichia coli were the main Gram-negative bacteria,accounting for 13.1%and 9.1%,which were more sensitive to cefoperazone/sulbactam,piperacillin/tazobactam,imipenem and meropenem.Conclusion Gram-positive bacteria,especially Staphylococcus aureus,was the predominant organism in DFO.