太仓地区糖尿病足部感染患者病原菌分布及药敏和耐药性分析

Distribution,Drug Susceptibility and Drug Resistance of Pathogenic Bacteria in Patients with Diabetic Foot Infection in Taicang Area

目的探究太仓地区糖尿病足部感染患者病原菌分布及药敏和耐药情况。方法将70例糖尿病足部感染分泌物阳性患者纳入本次研究中,收取时间段在2013年8月至2022年3月,对患者病原菌分布、药敏、耐药性进行分析。结果70例患者中,一共检出26种类细菌,均为革兰阳性菌感染33例(共计41株),占比47.14%;均为革兰阴性菌感染26例(共29株),占比37.14%;阳性菌与阴性菌混合感染11例(共计22株),占比15.71%。在均是革兰阳性菌感染中以金黄色葡萄球菌、无乳链球菌最常见,药敏提示它们对万古霉素、利奈唑胺、利福平、莫西沙星敏感性高,对青霉素、红霉素、克林霉素、苯唑西林耐药;均为革兰阴性菌感染的菌株较多,大肠埃希菌、肺炎克雷伯杆菌、奇异变形杆菌较多见,药敏提示对亚胺培南、氨曲南、环丙沙星、哌拉西林他唑巴坦、头孢哌酮钠舒巴坦敏感性高,少部分对头孢曲松、头孢呋辛耐药。阳性菌与阴性菌混合感染中,药敏提示它们对万古霉素、利奈唑胺、美罗培南、利福平、莫西沙星、哌拉西林舒巴坦敏感,对青霉素、红霉素、克林霉素、头孢呋辛、头孢曲松、头孢他啶、氨苄西林、环丙沙星、磺胺甲噁唑耐药,耐药率明显上升。结论太仓地区糖尿病足感染的致病菌分布广泛,经验性选择抗生素利于控制感染,病原学检测和药敏实验可为抗感染治疗提供精准依据。

Objective To investigate the distribution of pathogenic bacteria,drug sensitivity test and drug resistance in patients with diabetes foot infection in Taicang area.Methods Seventy patients with positive secretion of foot infection of diabetes were included in this study.The collection period was from August 2013 to March 2022.The distribution of pathogenic bacteria,drug sensitivity test and drug resistance of all patients were summarized and analyzed.Results Among the 70 patients,a total of 26 types of bacteria were detected,including 33 Gram positive patients(41 strains in total),accounting for 47.14%.There were 26 patients(29 strains)infected with Gram negative bacteria,accounting for 37.14%.There were 11 cases of mixed infections of Gram positive and negative bacteria(a total of 22 strains),accounting for 15.71%.Among all gram-positive bacterial infections,Glucococcus aureus and Streptococcus agalactiae were the most common.Drug sensitivity experiments showed that they are highly sensitive to vancomycin,linezolid,rifampicin and moxifloxacin,and most of them were resistant to penicillin,erythromycin,clindamycin,and oxacillin.The strains infected by all gram-negative bacteria are relatively wide.It can be seen that Escherichia coli,Klebsiella pneumoniae and Proteus mirabilisa are more common.Drug sensitivity tests suggest that they are highly sensitive to imipenem,aztreonam,ciprofloxacin,piperacillin tazobactam and cefoperazone sodium sulbactam,and a small part of them are resistant to ceftriaxone and cefuroxime.In the mixed infection of gram-positive bacteria and negative bacteria,the drug sensitivity test showed that it was more sensitive to vancomycin,linezolid,meropenem,rifampicin,moxifloxacin,piperacillin sulbactam,and resistant to penicillin,erythromycin,clindamycin,cefuroxime,ceftriaxone,ceftazidime,ampicillin,ciprofloxacin and sulfamethoxazole.The drug resistance rate increased significantly.Conclusions Pathogens of infected patients with diabetes foot in Taicang area are widely distributed,and empirical selection of broad-spectrum antibiotics is beneficial to control infection.Pathogenic detection and drug sensitivity test can provide accurate basis for anti infection treatment.