糖尿病足感染患者病原菌分布及相关性研究  

Distribution of pathogenic bacteria causing infections in diabetic foot patients and its correlation with severity of disease

作　　者：邓婷婷[1,2] 周素娴[1,2] 梁国荣[1,3] 

机构地区：[1]广西医科大学第四附属医院 [2]柳州市工人医院内分泌科,广西柳州545005 [3]柳州市工人医院骨科,广西柳州545005

出　　处：《中华医院感染学杂志》2013年第24期5945-5947,共3页Chinese Journal of Nosocomiology

基　　金：国家自然基金资助项目(8126034);广西壮族自治区卫生厅科研课题(2011GXNSFB018108);广西壮族自治区卫生厅中医药科技专项课题(GZKZ1146)

摘　　要：目的探讨糖尿病足感染的病原菌分布特点，以及其与疾病的严重程度的关系，以提高疗效。方法对内分泌科2009年1月一2013年6月收治的存在糖尿病足感染患者标本进行病原菌检测，采用法国生物梅里埃公司微生物鉴定仪及药敏系统进行细菌的培养、鉴定和药敏试验；将患者按照Wagner分级将其分为足溃疡1～5级，采用SPSS20．0软件进行统计分析，对潜在因素进行单因素分析，并利用logistic回归分析其与感染程度的关系。结果共纳入178例糖尿病足患者，其中163例患者发生感染，感染率为91．6％；共培养出病原菌204株，其中革兰阳性菌117株占57．4％，革兰阴性菌85株占41．6％、真菌2株占1．0％；统计分析结果显示，随着Wagner分级的递增，其感染程度加重及革兰阴性杆菌所占比例增加；多因素logistic回归分析显示，糖尿病足病程、感染类型及病原菌类型是Wanger分级的危险因素（P〈0．05）。结论糖尿病足病程长且存在革兰阴性菌为主的混合感染可增加Wagner分级的等级。OBJECTIVE To explore the characteristics of distribution of pathogens causing infections in the diabetm foot patients and analyze its correlation with the severity of disease so as to improve the efficacy. METHODS The pathogens were detected from the wound secretions that were obtained from the diabetic foot patients who were treated in the endocrinology department from Jan 2009 to Jun 2013, then the bacterial culture and identification were conducted with the use of microorganism identification system of BioMfirieux, France, the drug susceptibility testing was performed, the subjects were divided into 1%5 grades of foot ulcers according to the Wagner classifi- cation, the statistical analysis was performed with the use of SPSS20.0 software, the univariate analysis of the potential factors was carried out, and the logistic regression analysis of its correlation with severity of infection was performed. RESULTS A total of 178 cases of diabetic foot were included in the study, among which the infec- tions occurred in 163 cases with the infection rate of 91.6 %. Totally 204 strains of pathogens have been isolated, among which there were 117 （57.4%） strains of gram-positive bacteria, 85 （41. 6%） strains o% gram-negative bacteria, and 2 （1.0 %） strains of fungi. The statistical analysis indicated that with the increase of Wagner classification, the severity of infection and the proportion of gram-negative bacilli were increased ; the multivariate logistic regression analysis showed that the course of diabetic foot, types of infections, and species of pathogens were the risk factors for the Wanger classification. CONCLUSION The long course of diabetic foot and the mixed infections mainly caused by the gram-negative bacteria may increase the grade of Wagner classification.

关 键 词：糖尿病足 病原菌检测 Wanger分级 

分 类 号：R587.1[医药卫生—内分泌]