糖尿病足患者金黄色葡萄球菌感染的临床特点与耐药性分析  

Clinical characteristics and drug resistance analysis of diabetic foot infected by Staphylococcus aureus

作　　者：于学斌 彭跃进 史帅涛[2] 

机构地区：[1]郑州市第九人民医院内分泌科,河南郑州450053 [2]河南省人民医院血管外科,河南郑州450053

出　　处：《中华医院感染学杂志》2015年第16期3664-3666,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(0423032200)

摘　　要：目的探讨糖尿病足(DF)患者金黄色葡萄球菌(SAU)感染的临床特点及耐药性分析,以防止滥用抗菌药物提供参考依据。方法收集内分泌科2012年6月-2014年3月糖尿病足患者120例,采用自动细菌鉴定仪分离出38株SAU,采用K-B法进行药敏试验,观察糖尿病足SAU感染临床特点以及耐药性,数据采用SPSS 13.0软件进行统计分析。结果 120例糖尿病足患者送检样本检出SAU 38株,检出率为31.7%,其中检出耐甲氧西林SAU(MRSA)有28株检出率73.7%;SAU对万古霉素、替考拉宁、磺胺甲噁唑/甲氧苄啶及呋喃妥因的敏感率>80.0%,对青霉素与氨苄西林的耐药率为100.0%;MRSA的耐药率普遍高于MSSA耐药率,差异有统计学意义(P<0.05)。结论糖尿病足患者SAU感染多为深部溃疡引起的较严重感染,SAU对大部分抗菌药物耐药,并且MRSA存在多药耐药性,应指导临床合理用药。OBJECTIVE To investigate clinical characteristics and drug resistance of diabetic foot （DF） with Staph‐ylococcus aureus infection ,in order to provide references for preventing the abuse of antibiotics .METHODS Total‐ly 120 patients with DF from Jun .2012 to Mar .2014 in endocrinology department were collected ,and 38 strains of Staphylococcus aureus were separated by auto‐microbial‐identification instrument ,then drug sensitivity test was performed by K‐B method .The clinical features and drug resistance of SAU infection in patients with diabetic foot were observed .RESULTS A total of 38 strains of SAU were detected from the 120 cases of patients with diabetic foot ,and the detection rate was 31 .7% .Among them ,methicillin‐resistant S .aureus （MRSA） had 28 strains （73 .7 % ） .SAU had a drug resistance rate of over 80% to vancomycin ,teicoplanin ,sulfamethoxazole/trime‐thoprim and macrodantin .And they were 100% resistant to penicillin and ampicillin .Generally MRSA had higher drug resistance rate than MSSA and the difference between the two was significant （P〈0 .05） .CONCLUSION The SAU infection in patients with DF is mainly caused by deep ulcers ,which result in more serious infections . SAU is highly resistant to most antibiotics and is multiple‐drug resistant to MRSA .Clinical use of antibiotics should under guidance .

关 键 词：糖尿病足 金黄色葡萄球菌 临床特点 耐药性分析 

分 类 号：R378.11[医药卫生—病原生物学]