糖尿病足患者感染创面细菌分布及药敏试验结果分析

Distribution and sensitivity of bacteria in infected wounds of diabetes foot

目的分析糖尿病足患者感染创面的细菌分布及药敏试验结果。方法选择2021年6月—2022年10月福州市第二医院收治的84例确诊为糖尿病足患者作为研究对象,回顾并分析感染病菌的分布,探讨对抗菌药物的敏感性以及耐药性。结果革兰阴性(G^(-))菌、革兰阳性(G^(+))菌以及金黄色葡萄球菌、铜绿假单胞菌占比较高,分别为55.41%、42.52%、17.29%、11.82%。G^(+)菌对青霉素、红霉素的耐药率最高,分别为59.66%、51.40%;对万古霉素、替考拉宁的敏感率最高,分别为100.00%、99.03%。真菌对伊曲康唑、两性霉素B的药物敏感率均为100.00%,高于氟康唑(84.62%)。不同Wagner分级患者G-菌感染占比较大,1~2级构成比为21.95%,3~5级构成比为78.05%;其次为G+菌,1~2级构成比为33.87%,3~5级构成比为65.35%。结论多种病原菌可引发糖尿病足,且耐药率普遍较高。临床治疗应选择合理的干预措施,保持患者血糖水平正常,及时、多次开展病原学检查,从而寻找最适合的抗菌药物,促进患者早日恢复健康。

Objective To analyze the bacterial distribution and sensitivity in infected wound of diabetes foot.Methods From June 2021 to October 2022,84 patients with diabetes foot diagnosed in Fuzhou Second Hospital were selected as research objects.Results Gram negative(G^(-))bacteria,Gram positive(G^(+))bacteria,as well as Staphylococcus aureus and Pseudomonas aeruginosa accounted for relatively high proportions of 55.41%,42.52%,17.29%and 11.82%,respectively.The resistance rates of G^(+) bacteria to Penicillin and Erythromycin were the highest(59.66%and 51.40%).The sensitive rates to Vancomycin and Teicoplanin were the highest(100.00%and 99.03%).The sensitive rates of fungi to Itraconazole and Amphotericin B were both 100.00%,which were higher than Fluconazole(84.62%).The proportion of G-bacterial infection in patients with different Wagner grades was relatively high,with 21.95%for grades 1-2 and 78.05%for grades 3-5,and the next were G+bacteria,with 33.87%for grades 1-2 and 65.35%for grades 3-5.Conclusions A variety of pathogenic bacteria could cause diabetes foot,and the drug resistance rate is generally high.Clinical treatment should choose reasonable intervention measures to maintain normal blood sugar levels in patients,conduct timely and multiple pathogen tests,in order to find the most suitable antibacterial drugs and promote patients to recover their health as soon as possible.