糖尿病足发生多药耐药菌感染的相关影响因素分析  

Analysis of relevant influencing factors causing multi drug-resistant organism infections to diabetic foot patients

作　　者：徐娜[1] 苏雅琳[1] 金文波[1] 

机构地区：[1]南阳市中心医院内分泌代谢科,河南南阳473009

出　　处：《中华医院感染学杂志》2014年第12期2995-2997,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(30973087)

摘　　要：目的分析糖尿病足发生多药耐药菌(MDROs)感染的相关影响因素,并探讨预防对策。方法选取2008年3月-2011年4月收治的209例糖尿病足患者,按照其是否发生MDROs感染分为感染组66例及非感染组143例,使用单因素及多因素分析回顾性分析其影响因素。结果 209例患者中共发生MDROs感染66例,感染率31.6%;共检出MDROs 102株,其中以金黄色葡萄球菌、铜绿假单细胞菌为主,分别占44.1%、21.7%;两组患者年龄、病程、体质量指数、溃疡病程比较,差异无统计学意义;多因素回归分析显示,抗菌药物使用史、因同一伤口住院次数>2次、合并骨髓炎及出现神经缺血性伤口是影响糖尿病足发生MDROs感染的独立危险因素(P<0.05)。结论上述因素可直接导致患者发生MDROs感染,应规范抗菌药物的使用、控制患者血糖并积极治疗原发病,以改善患者免疫功能,减少MDROs的产生,降低糖尿病足患者MDROs感染率。OBJECTIVE To analyze the relevant influencing factors causing multi drug-resistant organism infections （MDROs） to diabetic foot ,and to explore the preventive countermeasures .METHODS A total of 209 cases of diabetic foot patients treated in the hospital from Mar 2008 to Apr 2011 were selected ,and according to the criteria whether the patients suffered MDROs ,these patients were divided into infection group （66 cases） and non-infection group （143 cases）;single factor and multiple factor analysis methods were adopted for retrospectively analyzing the influencing factors .RESULTS Totally ,66 of the 209 patients suffered MDROs infection ,with an infection rate of 31 .6% ;a total of 102 strains of MDROs were detected ,with Staphylococcus aureus ,and Pseud-omonas aeruginosa dominantly accounting for 44 .1% and 21 .7% ;there was no significant difference between the ages ,disease courses ,body mass indexes ,and ulcer courses of the two groups of patients ;the multi-factor regression analysis indicated that history of antibiotics use ,more than 2 times of hospitalization for the same incision ,complicated osteomyelitis and occurrence of neurological ischemic wound were those independent risk factors causing MDROs infection to DF （P〈 0 .05） .CONCLUSIONS The above factors can directly lead MDROs infection to patients ,so it is required to standardize the use of antibiotics ,control the blood glucose and actively treat primary disease , so as to improve immune function of patients , reduce the production of MDROs , and decrease the MDROs infection rate in DF patients .

关 键 词：糖尿病足 多药耐药菌 感染 影响因素 

分 类 号：R181.32[医药卫生—流行病学]