糖尿病足患者感染病原菌分布及抗菌药物的应用  

Distribution of pathogenic bacteria in diabetic foot patients infection and antibiotics use

作　　者：关泰宇[1] 关小宏[2] 李宝军[3] 

机构地区：[1]河北联合大学研究生学院,河北唐山063000 [2]空军总医院内分泌科,北京100142 [3]空军总医院干部病房,北京100142

出　　处：《中华医院感染学杂志》2014年第3期577-579,共3页Chinese Journal of Nosocomiology

基　　金：空军总医院科研基金项目(KZ9931

摘　　要：目的通过对糖尿病足患者感染的细菌谱变化及药敏性进行分析,为临床医师治疗糖尿病足感染中抗菌药物选择提供依据。方法收集2006年1月1日-2011年12月31日医院内分泌科收治的糖尿病足感染患者临床资料,细菌鉴定采用法国生物梅里埃公司的VITEKAMS-60全自动微生物鉴定系统进行检测分析,采用美国临床实验室标准化研究所(CLSI)2008年推荐的纸片扩散法(K-B)测定其对抗菌药物的敏感性。结果糖尿病足患者的834份送检标本中,629份培养阳性,阳性率为75.41%;其中革兰阴性菌感染逐年下降,从2006年的55.06%下降至2011年的43.33%;革兰阳性菌感染逐年上升,从2006年的43.82%上升至2011年的53.34%;铜绿假单胞菌对头孢西丁、氨苄西林、亚胺培南、美罗培南等敏感率较高,分别为91.67%、97.62%、83.33%、89.29%,金黄色葡萄球菌、粪肠球菌对亚胺培南、万古霉素、利奈唑胺的敏感率均为100.00%。结论了解医院常见病原菌分布及耐药变迁,对有效控制感染、合理使用抗菌药物具有重要指导作用。OBJECTIVE To analyze the change of bacterial spectrum strains of diabetic foot infection and drug sensitivity, so as to bring up the basis to clinician to choose antibiotics in diabetic foot infection treatment. METHODS Clinical data of diabetic foot infection patients were collected and systemized from Jan. 1, 2006 to Dec. 31, 2011 in Air Force General Hospital endocrinology department. Bacteria were detected and analyzed by VITEKAMS-60, a fully automatic microbial identification system from French Biomerieux company. The sensitiv- ity of bacteria to antibiotics was tested by Kirby-Bauer（K-B） recommended by American Clinical Laboratory Standard Institution （CLSI）in 2008. RESULTS In the total 834 samples of diabetic foot infections, 629 （75.41%） were positive. The infection rate of gram-negative bacteria decreases year by year, which dropped from 55.06 % to 43.33% during 2006 to 2011. gram-positive bacteria infection increases year by year, which rised from 43.82% to 53. 34% during 2006 to 2011; Pseudomonas aeruginosa had a high sensitive rates to cefoxitin （91. 67%）, ampicillin（97.62%）, imipenem（83.33%）, meropenem（89.29%） . Sensitive rates of Staphylococcus aureus and Enterococcus faecalis to imipenem, vancomycin, linezolid were all 100. 00%. CONCLUSION Further understanding about common pathogenic bacteria distribution and drug-fast change has important directive function to control infections effectively and use antibacterial agents rationally.

关 键 词：糖尿病足 感染 病原菌 药敏率 

分 类 号：R587.1[医药卫生—内分泌]