糖尿病足感染92例病原菌分布特点及耐药性分析

Distribution characteristics and drug resistance of pathogenic bacteria in 92 patients with diabetic foot infection

目的分析糖尿病足感染的病原菌分布特点及耐药性,为指导临床用药提供理论依据。方法抽取2020年12月至2021年12月郑州大学附属郑州中心医院收治的糖尿病足患者126例,统计病原菌检出、分布情况及主要病原菌的耐药情况。结果126例糖尿病足患者中92例合并感染,感染发生率为73.02%,从足部溃疡分泌物中分离出病原菌101株,其中革兰阳性菌49株(48.52%),革兰阴性菌50株(49.50%),真菌2株(1.98%)。主要革兰阳性菌中金黄色葡萄球菌、表皮葡萄球菌对青霉素及氨苄西林的耐药率≥90.00%,金黄色葡萄球菌、粪肠球菌、表皮葡萄球菌对替考拉宁、利奈唑胺、万古霉素的耐药率为0。主要革兰阴性菌中铜绿假单胞菌、大肠埃希菌对氨苄西林的耐药率>90.00%,铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌对美罗培兰及亚胺培南的耐药率为0。结论糖尿病足患者感染发生率较高,且耐药状况普遍,临床上应结合药敏试验结果合理使用抗菌药。

Objective To analyze the distribution characteristics and drug resistance of pathogenic bacteria of diabetic foot infection,and provide a theoretical basis for guiding clinical medication.Methods A total of 126 diabetic foot patients admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from December 2020 to December 2021 were selected.The detection result and distribution of pathogenic bacteria and the drug resistance of the main pathogenic bacteria were counted.Results Among the 126 diabetic foot patients,92 cases were infected,and the infection rate was 73.02%;101 strains of pathogenic bacteria were isolated from the secretion of foot ulcer,including 49 strains(48.52%)of Gram-positive bacteria,50 strains(49.50%)of Gram-negative bacteria,and 2 strains(1.98%)of fungi.Among the main Gram-positive bacteria,the resistance rate of Staphylococcus aureus and Staphylococcus epidermidis to penicillin and ampicillin was≥90.00%,while the resistance rate of Staphylococcus aureus,Enterococcus faecalis and Staphylococcus epidermidis to teicoplanin,linezolid and vancomycin were 0.The resistance rate of Pseudomonas aeruginosa and Escherichia coli among the main Gram-negative bacteria to ampicillin were>90.00%,while the resistance rate of Pseudomonas aeruginosa,Escherichia coli and Acinetobacter baumannii to meropenem and imipenem were 0.Conclusions The incidence of infection in diabetic foot patients is high,and the drug resistance is common.Antibiotics should be used rationally according to the results of drug susceptibility tests in clinical.