糖尿病足溃疡处病原菌分布情况及耐药性分析  

Analysis of Distribution of Pathogenic Bacteria in Diabetic Foot Ulcer and Drug Resistance

作　　者：梁家隐[1] 廖小倩 黄凡华 

机构地区：[1]中山大学附属第三医院检验科,广东广州510630

出　　处：《糖尿病新世界》2016年第18期3-5,共3页Diabetes New World Magazine

摘　　要：目的观察糖尿病足溃疡分泌物病原菌分布情况及其耐药性分析,指导临床用药。方法回顾性分析2012年1月—2015年12月期间该院糖尿病患者足溃疡分泌物分离的292株病原菌的分布情况及其耐药性。结果糖尿病足病原菌以革兰阳性球菌为主(56.8%),其次是革兰阴性杆菌(39.7%)和真菌(3.5%);其中革兰阳性球菌以金黄色葡萄球菌比例最多,占42.2%,溶血性葡萄球菌占20.5%;而革兰阴性杆菌的分布为变形杆菌占25.9%,铜绿假单胞菌占24.1%。其药敏结果显示,在金黄色葡萄球菌中,对莫西沙星耐药率为0,MRSA占22.5%,未见对万古霉素、利奈唑胺、达托霉素耐药的革兰氏阳性菌;亚胺培南对革兰阴性杆菌抗菌敏感性较高,其他常用抗菌药均有不同程度的耐药。结论糖尿病足溃疡处病原菌分布以革兰阳性菌为主,万古霉素和莫西沙星有较高抗菌活性。通过对糖尿病足感染的病原菌及耐药性进行监测,及时调整抗菌药物,减少耐药菌产生。Objective To observe the distribution of pathogenic bacteria in diabetic foot ulcer and drug resistance to provideguidance for clinical medication. Methods The distribution and drug resistance of 292 strains of pathogenic bacteria isolatedfrom foot ulcer secretions in patients with diabetes in our hospital from January 2012 to December 2015 were retrospectivelyanalyzed. Results Diabetic foot pathogenic bacteria were mainly gram positive coccus （56.8%）, the second was gramnegative bacilli （39.7%） and fungus （3.5%）, and the gram positive coccus was mainly staphylococcus aureus, accounting for42.2%, and the staphylococcus simulans accounted for 20.5%, and in the distribution of gram negative bacilli, bacillus termoaccounted for 25.9% and pseudomonas aeruginosa accounted for 24.1%, and the drug-sensitivity results showed that inthe staphylococcus aureus, the drug resistance to moxifloxacin was 0, MRSA accounted for 22.5%, and there was no grampositivebacterium resistant to vacocin vancomycin, linezolid and daptomycin, the sensitivity of imipenem to gram-negativebacilli was higher, and other common antibiotic drugs all had different degrees of resistances. Conclusion The distributionof pathogenic bacteria in diabetic foot ulcer is mainly gram positive bacteria, vacocin vancomycin and moxifloxacin havehigher antimicrobial activity, and we should adjust the antibiotic drugs in time and reduce the occurrence of drug-resistancebacteria by monitoring the pathogenic bacteria in diabetic foot infection and drug resistance.

关 键 词：糖尿病足溃疡 病原菌 耐药性 

分 类 号：R59[医药卫生—内科学]