糖尿病足患者感染病原菌分布特点及对抗菌药物的敏感性分析  

Distribution of pathogenic bacteria in diabetic foot infection and their sensitivity to antibiotics

作　　者：肖贵宝[1] 陶世冰[2] 陈刚[3] 宋敏[4] XIAO Gui-bao;TAO Shi-bing;CHEN Gang;SONG Min(The First People＇s Hospital of Ziyang , Ziyang, Sichuan 641300, China)

机构地区：[1]资阳市第一人民医院感染性疾病科,四川资阳641300 [2]资阳市第一人民医院内分泌科,四川资阳641300 [3]资阳市第一人民医院重症医学科,四川资阳641300 [4]资阳市第一人民医院临床药学室,四川资阳641300

出　　处：《中华医院感染学杂志》2018年第7期1033-1036,共4页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科研基金资助项目(2011110089)

摘　　要：目的探讨糖尿病足患者感染病原菌的分布特点,分析病原菌对抗菌药物的敏感性。方法选取2011年10月-2016年12月医院收治的116例糖尿病足患者为研究对象,采集患者的溃疡分泌物进行分泌物培养和药敏试验,应用全自动微生物鉴定仪系统进行挑选和病原菌培养,分析患者的病原菌分布特点与抗菌药物敏感性。结果 116例糖尿病足患者分泌物共培养出109株菌株,其中包括革兰阳性球菌26株,革兰阴性杆菌78株,真菌5株;有5例标本出现混合性感染,其中l例为普通变形杆菌、大肠埃希菌混合感染,2例为链球菌、大肠埃希菌混合感染,2例为表皮葡萄球菌、大肠埃希菌混合感染,未出现两种以上细菌混合感染现象。近平滑假丝酵母与白假丝酵母均对现用抗真菌药物敏感,敏感率为100.00%;革兰阳性球菌对呋喃妥因、利奈唑烷、替考拉宁的敏感性较高;革兰阴性杆菌对头孢吡肟、亚胺培南、哌拉西林、头孢替坦、厄他培南等的敏感性较高。结论糖尿病足患者的溃疡创面感染病原菌主要为革兰阴性杆菌,其次为革兰阳性球菌,不同病原菌的敏感抗菌药物不同,临床可结合药敏试验选择合适的抗菌药物进行治疗。OBJECTIVE To summarize the distribution characteristics of different pathogens in diabetic foot infection,and to analyze the drug sensitivity.METHODS A total of 116 patients with diabetic foot from Oct.2011 to Oct.2016 treated in our hospital were enrolled in the study.secretion culture and drug sensitivity test were carried out,the automatic microorganism identification system was used for selection and pathogen culture,and the distribution characteristics of the pathogenic bacteria and antimicrobial susceptibility of the patients were analyzed.RESULTS A total of 109 strains of pathogens were isolated from 116 cases of the patients with diabetic foot,including 26 strains of gram-positive bacteria,78 strains of gram-negative bacteria and 5 strains of fungi.In addition,5 cases were mixed infections,including 1 case of mixed infection of Proteus vulgaris and Escherichia coli,2 cases of mixed infection of Streptococcus and E.coli,2 cases of mixed infection of Staphylococcus epidermidis and E.coli,and no case of mixed infection with more than two kinds of bacteria.Candida parapsilosis and Candida albicans were sensitive to commonly used antibiotics,and the sensitivity reached 100%.Gram-positive bacteria had high sensitive rates to nitrofurantoin,linezolid and teicoplanin,and gram-negative bacteria had high sensitive rates to cefepime,imipenem,piperacillin,cefotetan,and ertapenem.CONCLUSIONThe main pathogenic bacteria of infection of ulcerative wound in patients with diabetic foot were gram-negative bacteria,followed by gram-positive bacteria.Different pathogens have different antimicrobial agents,and we can select suitable antibiotics for treatment by the combination of drug sensitivity test.

关 键 词：糖尿病足 感染 病原菌 药敏试验 抗菌药物 

分 类 号：R587.2[医药卫生—内分泌]