不同Wagner分级糖尿病足患者创面病原菌分布特点  

Distribution characteristics of pathogenic bacteria on the wound surface of patients with different Wagner grade diabetic foot

作　　者：王红梅[1] 石锋[1] 吴永新[1] 马苑霞 WANG Hong-mei(Department of endocrinology,Meizhou people's hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院内分泌科

出　　处：《牡丹江医学院学报》2019年第6期40-42,共3页Journal of Mudanjiang Medical University

基　　金：梅州市医药卫生科研项目(2016-B-37)

摘　　要：目的探究不同Wagner分级糖尿病足患者创面病原菌分布特点。方法选取我院2016年10月至2018年9月间收治的94例糖尿病足患者进行研究,采集创面分泌物分析病原菌的分布特点。结果94例患者培养菌株85株,阳性率90.43%(85/94),其中革兰阳性菌42株,革兰阴性菌43株。Wagner等级越高,革兰阴性菌占比越高,不同Wagner等级革兰阴性菌占比差异有统计学意义(P<0.05)。革兰阳性菌中,不同Wagner等级多重耐药菌主要以金黄色葡萄球菌、表皮葡萄球菌为主,占比分别为45.24%(19/42)、30.95%(13/42),同其它相比差异有统计学意义(P<0.05);格兰阴性菌中,不同Wagner等级多重耐药菌主要以布氏柠檬酸杆菌、大肠埃希菌、铜绿假单胞菌为主,占比分别为41.86%(18/43)、25.58%(11/43)、16.28%(7/43),同其它相比差异有统计学意义(P<0.05)。结论糖尿病足患者不同Wagner分级创面分离病原菌分布存在差异,对于Wagner分级较高的患者要重点进行病原学检查,行药敏试验,为临床合理使用抗菌药物提供依据。Objective To explore the distribution characteristics of pathogenic bacteria on the wound surface of patients with diabetic foot in different Wagner grades.Methods 94 patients with diabetic foot admitted to our hospital from October 2016 to September 2018 were selected for study,wound secretions were collected to analyze the distribution characteristics of pathogenic bacteria.Results 85 strains were cultured in 94 patients,with a positive rate of 90.43%(85/94).Among the 85 strains,42 strains were gram-positive and 43 strains were gram-negative.The higher Wagner grade was,the higher the proportion of gram-negative bacteria was,and the difference in the proportion of gram-negative bacteria in different Wagner grades was statistically significant(P<0.05).Among the gram-positive bacteria,staphylococcus aureus and staphylococcus epidermidis were the main multidrug-resistant bacteria in different Wagner grades,accounting for 45.24%(19/42)and 30.95%(13/42),respectively,and the difference was statistically significant(P<0.05).Among gram-negative bacteria,citrobacter brucei,escherichia coli and pseudomonas aeruginosa in different Wagner levels were the main multi-drug resistant bacteria,accounting for 41.86%(18/43),25.58%(11/43)and 16.28%(7/43),respectively,and the difference was statistically significant(P<0.05).Conclusion There are differences in the distribution of pathogenic bacteria isolated from the wound surface in patients with diabetic foot with different Wagner grading.For patients with higher Wagner grading,it is important to focus on pathogen examination and drug sensitivity test,so as to provide evidence for rational use of antimicrobial agents in clinical practice.

关 键 词：糖尿病足 病原菌 分布特点 合理用药 

分 类 号：R587.2[医药卫生—内分泌]