151份糖尿病足患者药敏报告及指导用药情况分析  

Analysis of Susceptibility Reports and Medication Guidance in 151 Patients with Diabetic Foot

作　　者：梁晋川[1] 柯洪[1] 郑行林[1] 

机构地区：[1]成都中医药大学附属医院药剂科,成都610072

出　　处：《中国药房》2014年第10期902-904,共3页China Pharmacy

摘　　要：目的：分析糖尿病足感染病原菌及药敏检查结果指导抗生素运用情况，为选择最优的抗感染方案提供参考。方法：收集、对比某医院内分泌科2012年6月--2013年6月糖尿病足分泌物病原菌培养及药敏结果的处理情况，发现其中的问题并进行探讨与分析。结果：糖尿病足分泌物感染革兰阳性菌以金黄色葡萄球菌、溶血葡萄球菌、类香味菌为主；革兰阴性菌以鲍曼不动杆菌、大肠埃希菌、变形杆菌为主。以金黄色葡萄球菌耐药情况尤为突出。常用抗生素以氨曲南、左氧氟沙星、头孢哌酮／他唑巴坦为主。临床运用抗生素时药敏试验的覆盖率达51．56％，未做细菌培养及药敏试验的患者多以病情较轻（0～1级）或无分泌物为主。药敏结果敏感占78．15％，耐药占12．58％，中介占5．96％。预后良好占93．38％，预后不好占6．62％。结论：糖尿病足感染的患者在该院临床抗生素使用及预后结果情况较好。由于影响糖尿病足感染的病原菌及药敏的因素是多方面的，认真地对待每一个细节是提高疗效的基础，尤其是处理好“耐药”“中介”情况下抗生素的调整。OBJECTIVE： To analyze the pathogenic bacteria of diabetic foot infection and results of susceptibility test, to pro- vide reference for choosing the optimal scheme of anti-infection. METHODS： The pathogenic bacteria culture and drug susceptibility results of diabetic foot secretions in endocrinology department of a hospital during Jun. 2012- Jun. 2013 were collected and com- pared to find, discuss and analyze the problems. RESULTS： Gram-positive bacteria of diabetic foot secretions were mainly Staphylo- coccus aureus, Hemolysis S. bacteria and Myroides odoratus. Gram-negative bacteria were mainly Acinetobacter baumannii, Esche- richia coli and Bacillus proteus. Drug resistance of Staphylococcus aureus was particularly severe. Commonly used antibiotics were mainly aztreonam, levofloxacin, cefoperazone/tazobactam. The coverage of antibiotics susceptibility test was 51.56%. The patients with slight illness （0-1 grade） or without secretions didn＇t received germiculture and drug susceptibility test. In drug susceptibility test, ＂sensitive＂ accounted for 78.15%, ＂resistance＂ for 12.58%, ＂mediation＂ for 5.96%, Good prognosis accounted for 93.38%, and poor prognosis accounted for 6.62%. CONCLUSIONS： For patients with diabetic foot infection, clinical use of antibiotics and prognosis in the hospital were relatively good. Due to various influential factors of pathogenic bacteria and drug susceptibility of dia- betic foot infection, It is important to treat detail seriously, which is foundation for improving curative effect, especially to deal with the adjustment of antibiotics in ＂resistance＂ and ＂medium＂ cases.

关 键 词：糖尿病足 感染 病原菌谱 敏感性 抗感染 

分 类 号：R587.2[医药卫生—内分泌] R969.3[医药卫生—内科学]