糖尿病足混合细菌感染特征及影响因素分析  

Characteristics and Influencing Factors of Mixed Bacterial Infection in Diabetic Foot

作　　者：詹桂桂 杨少玲[2] 宋潇萌 朱旅云[2] ZHAN Gui-gui;YANG Shao-ling;SONG Xiao-meng;ZHU Lv-yun(Graduate School of Chengde Medical University,Chengde,Hebei 067000,China;Department of Endocrinology,Bethune International Peace Hospital of PLA,Shijiazhuang 050082,China;Graduate School of Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]承德医学院研究生学院,河北承德067000 [2]解放军白求恩国际和平医院内分泌科,石家庄050082 [3]河北医科大学研究生学院,石家庄050017

出　　处：《临床误诊误治》2018年第3期92-95,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省自然科学基金资助项目(H2013505067)

摘　　要：目的探讨糖尿病足混合细菌感染特征及影响因素。方法选取我院2010年6月—2017年3月收治的糖尿病足溃疡114例,观察细菌培养结果,比较混合细菌感染例数、菌谱特征及耐药性,分析混合细菌感染影响因素。结果本组细菌培养阳性105例,其中单一细菌感染59例(56.2%),混合细菌感染46例(43.8%),且混合细菌感染率随着病情严重程度的升高而升高。混合细菌感染以革兰阳性菌+革兰阴性菌、革兰阴性菌+革兰阴性菌为主,且混合细菌感染中多重耐药菌感染20例,感染率为43.5%,培养多重耐药菌32株,居前三位分别为金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌。Logistic逐步回归分析显示,足部溃疡病程、抗生素药物史、Wagner分级、踝臂指数、经皮氧分压是糖尿病足混合细菌感染的危险因素。结论了解混合细菌感染特征及相关影响因素,加强抗感染及预防措施,可改善糖尿病足患者预后。Objective To study characteristics and influencing factors of mixed bacterial infection in diabetic foot.Methods A total of 114 patients with diabetic foot ulcer treated by our hospital from June 2010 to March 2017 were enrolled.The result of bacterial culture was observed,and the number of mixed bacterial infections,spectrum features and drug resistance were compared.In addition,the influencing factors of mixed bacterial infection were analyzed.Results There were 105 positive bacterial cultures in this group,including 59 with single bacterial infection(56.2%)and 46 with mixed bacterial infections(43.8%).The bacterial infection rate was increased with the severity of the disease.Mixed bacterial infections involved predominantly gram-positive+gram-negative bacteria,as well as gram-negative+gram-negative bacteria,including 20 cases of multidrug-resistant bacteria with an infection rate of 43.5%.Moreover,32 strains of multidrug-resistant bacteria were developed,and the top three were Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa.Logistic stepwise regression analysis showed that the course of foot ulcers,history of antibiotics,Wagner grade,ABI and low transcutaneous oxygen pressure(TcPO 2)were risk factors for mixed bacterial infection.Conclusion The prognosis of patients with diabetic foot can be improved by gaining insight into bacterial characteristics and associated influencing factors in mixed bacterial infections,and by strengthening anti-infection and prevention measures.

关 键 词：糖尿病足 细菌感染 影响因素分析 

分 类 号：R587.29[医药卫生—内分泌]