糖尿病足溃疡患者病原菌分布特点及耐药性分析  

Distribution and drug resistance analysis of pathogens in patients with diabetic foot ulcer

作　　者：周莉莉[1] 周砚[1] 王运林[1] ZHOU Lili;ZHOU Yan;WANG Yunlin(Department of Endocrinology,Foshan Second People′s Hospital,Guangdong Province,Foshan 528000,China)

机构地区：[1]广东省佛山市第二人民医院内分泌科,广东佛山528000

出　　处：《中国当代医药》2022年第7期86-88,92,共4页China Modern Medicine

基　　金：广东省佛山市自筹经费类科技计划项目(2017AB002031)。

摘　　要：目的探讨糖尿病足溃疡(DUF)患者病原菌分布特点及耐药性。方法选择2018年1月至2019年12月佛山市第二人民医院收治的134例DUF患者为研究对象,采集标本行细菌培养和药敏试验,分析DUF患者的病原菌分布情况及其药敏试验结果。结果134份标本中共检出病原菌142株,其中革兰氏阳性菌67株,革兰氏阴性菌59株,真菌16株;金黄色葡萄球菌对替加环素、利奈唑胺和万古霉素的敏感率为100.00%,对以厄他培南为代表的碳青霉烯类、氨基糖苷类药物的敏感率可达70%;粪肠球菌对替加环素、利奈唑胺和万古霉素和以厄他培南为代表的碳青霉烯类、氨基糖苷类药物的敏感率可达到60%;大肠埃希菌对厄他培南的敏感率为100.00%,对哌拉西林-他唑巴坦、庆大霉素、阿米卡星的敏感率>60%;肺炎克雷伯菌对厄他培南、氨曲南、阿米卡星、庆大霉素、左氧氟沙星、环丙沙星、莫西沙星、头孢唑肟的敏感率>75%,对哌拉西林-他唑巴坦、头孢哌酮-舒巴坦的敏感率>65%;铜绿假单胞菌仅对哌拉西林-他唑巴坦的敏感率>60%。结论革兰氏阳性菌与革兰氏阴性菌是DUF的主要病原菌,两者耐药性存在明显差异,临床需针对细菌耐药性变化实施检测,按照检测结果合理使用抗菌药物。Objective To investigate the distribution and drug resistance of pathogens in patients with diabetic ulcer foot(DUF).Methods A total of 134 cases of DUF patients admitted to Foshan Second People′s Hospital from January 2018 to December 2019 were selected as the research objects.The samples were collected for bacterial culture and drug sensitivity test,and the distribution of pathogens and drug sensitivity test results of DUF patients were analyzed.Results A total of 142 strains of pathogenic bacteria were detected in 134 samples,included 67 strains of Gram-positive bacteria,59 strains of Gram-negative bacteria and 16 strains of fungi.The sensitivity rate of Staphylococcus aureus to Tigecycline,Linezolid and Vancomycin were 100.00%,and the sensitivity rate to Carbapenems and Aminoglycosides represented by Ertapenem were 70%.The sensitivity rate of Enterococcus faecalis to Tigecycline,Linezolid,Vancomycin and Carbapenems and Aminoglycosides represented by Ertapenem were 60%.The sensitivity rate of Escherichia coli to Ertapenem was 100.00%,and that to Piperacillin Tazobactam,Gentamicin and Amikacin were more than 60%.The sensitivity rate of Klebsiella pneumoniae to Ertapenem,Aztreonam,Amikacin,Gentamicin,Levofloxacin,Ciprofloxacin,Moxifloxacin and Cefazoxime were more than 75%,and that to Piperacillin Tazobactam and Cefoperazone Sulbactam were more than 65%.The sensitivity rate of Pseudomonas aeruginosa to Piperacillin Tazobactam was only more than 60%.Conclusion Gram-positive bacteria and Gram-negative bacteria are the main pathogens of DUF.There are obvious differences in drug resistance between them.Clinically,it is necessary to detect the changes of bacterial drug resistance and use antibiotics reasonably according to the test results.

关 键 词：糖尿病足溃疡 病原菌分布 耐药性 药敏试验 

分 类 号：R587.2[医药卫生—内分泌]