糖尿病足患者伤口感染多重耐药菌分布及耐药性分析  

Distribution and drug resistance of multidrug-resistant organisms in diabetic foot patients with wound infection

作　　者：江琰笛[1] 朱晶晶 陶崑[1] 张勇[1] 张恩[2] JIANG Yan-di;ZHU Jing-jing;TAO Kun;ZHANG Yong;ZHANG En(Ningbo No.6 Hospital,Ningbo Zhejiang 315040;Ningbo Medical Center Li Huili Hospital,China)

机构地区：[1]宁波市第六医院,浙江宁波315040 [2]宁波市医疗中心李惠利医院

出　　处：《中国消毒学杂志》2020年第1期24-26,共3页Chinese Journal of Disinfection

基　　金：宁波市自然基金项目(2017A610280)

摘　　要：目的了解糖尿病足者伤口感染的多重耐药菌(MDROs)分布及其耐药特征,为其预防和控制感染提供科学依据。方法通过回顾性分析方法,对某医院住院糖尿病足感染患者送检标本分离的MDROs分布及其药敏试验资料进行统计分析。结果在收治的223例糖尿病足感染患者中,有88例分离出MDROs,占感染病例总数的39. 46%。共培养出MDROs 118株,居前3位的是金黄色葡萄球菌、大肠埃希菌和变形杆菌,构成比依次为35. 6%、21. 2%和18. 6%。多因素Logistic回归分析显示,多次清创、混合感染、近3个月使用三代头孢、联合用药、截肢、骨髓炎、神经缺血性伤口、Wagner分级≥4级是糖尿病足感染MDROs的独立危险因素。结论糖尿病足感染MDROs的比例较高,应针对高危因素加强防控措施。Objective To investigate the distribution and drug resistance of multidrug-resistant organisms( MDROs) in diabetic foot patients with wound infection,and to provide scientific basis for prevention and control of infection. Methods By retrospective analysis,the distribution of MDROs isolated from the samples of diabetic foot patients with infection in a hospital and the data of drug sensitivity test were analyzed. Results Among 223 cases of diabetic foot patients with infection,88 cases were isolated MDROs,accounting for 39. 46% of the total cases. A total of 118 MDROs strains were cultured,and the top three strains were Staphylococcus aureus,Escherichia coli and Proteus,with the composition ratios of35. 6%,21. 2% and 18. 6% respectively. The multivariate Logistic regression analysis showed that multiple debridement,mixed infection,use of the third generation of cephalosporins in recent 3 months,drug combination,amputation,osteomyelitis,neurological ischemic wound,Wagner grade ≥4 were the independent risk factors of MDROs infection in diabetic foot.Conclusion The infection rate of MDROs in diabetic foot is high,and the prevention and control measures should be strengthened according to the high risk factors.

关 键 词：糖尿病足 医院感染 多重耐药菌 耐药性 危险因素 

分 类 号：R378[医药卫生—病原生物学]