88例糖尿病足感染的病原菌分布和药敏分析  

Distribution and antibiotic susceptibility of pathogens isolated from 88 patients with diabetic foot infection in northern district of Chengdu

作　　者：邱平[1] 梅希[1] 唐明薇[1] 廖戮缪 卢迪[1] 杨惠岚[1] 兰天[1] 黎瑶[1] 

机构地区：[1]成都医学院第一附属医院内分泌代谢科,四川成都610500

出　　处：《吉林医学》2016年第2期290-293,共4页Jilin Medical Journal

基　　金：四川省卫生厅课题[项目编号:120478]

摘　　要：目的：了解成都市北部地区糖尿病足感染的病原菌分布及药物敏感情况,为选择最佳的抗感染方案提供参考。方法：回顾性分析成都医学院第一附属医院内分泌代谢科2012年7月-2014年7月糖尿病足分泌物病原菌培养及药敏结果的处理情况。结果：共搜集到88例糖尿病足溃疡伴感染患者,糖尿病足分泌物感染以革兰阳性菌为主,其中革兰阳性菌以金黄色葡萄球菌、溶血葡萄球菌、粪肠球菌为主;革兰阴性菌以普通变形杆菌、产酸克雷伯氏菌、阴沟肠杆菌为主。粪肠球菌耐药率明显。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。革兰阳性球菌对万古霉素、力奈唑烷、左氧氟沙星及莫西沙星较为敏感,革兰阴性菌对亚胺培南、美罗培南、氨基糖甙类及β-内酰胺酶抑制剂的抗菌药物、氨曲南较为敏感。结论：糖尿病足感染的病原菌分布广泛,耐药率高,早期、多次培养并根据药敏选择抗菌药物治疗是糖尿病足感染治疗的关键。Objective To investigate the distribution and antibiotic susceptibility of pathogens isolated from patients with diabetes foot ulcer in northern district of Chengdu; to provide a reference for the selection of optimal anti- infected programs. Method Pathogens with diabetic foot ulcers and antibiotic sensitivity results were analyzed from July,2012 to July,2014 retrospectively. All datas obtained from hospitalized patients in department of endocrinology of First Affiliated Hospital of Chengdu Medical College. Results A total of infected 88 cases were collected with diabetic foot ulcers,including Gram- positive bacteria with majority of Staphylococcus aureus、hemolytic staphylococci and Enterococcus faecalis; Gram- negative bacteria with majority of Bacillus proteus vulgaris、Klebsiella oxytoca and Enterobacter cloacae. Gram- positive bacterias were sensitive to vancomycin,linezolid,levofloxacin and Moxifloxacin. Gram- negative bacterias were sensitive to Imipenem,Meropenem,Aminoglycosides andβ- lactamases inhibitor、Aztreonam. Enterococcus faecalis was the obviously common resistant strain. Patients without sampling mostly were mild（ Wagner Grade 0 - 1） or had no discharge. Conclusion The pathogens with diabetic foot infection are distributed extensively and most of them had high resistance rates. Repeatedly collection of the discharge at early stage and choose the sensitive antimicrobial agents based on susceptibility analysis are important to treatment of diabetic foot infections.

关 键 词：糖尿病足感染 溃疡 病原菌 药敏 

分 类 号：R446.5[医药卫生—诊断学]