糖尿病足患者感染创面病原菌的分布及其耐药性分析  

Distribution and drug resistance analysis of pathogenic bacteria in infected wounds of diabetic foot patients

作　　者：吕福平 张蔓菁[1] LYU Fuping;ZHANG Manjing(Department of Endocrinology and Diabetes,the First Affiliated Hospital of Xiamen University,Fujian Province,Xiamen350108,China)

机构地区：[1]厦门大学附属第一医院内分泌糖尿病科,福建厦门350108

出　　处：《中国当代医药》2022年第25期105-107,共3页China Modern Medicine

摘　　要：目的探讨糖尿病足(DF)患者感染创面病原菌的分布及其耐药性。方法选取2017年5月至2019年4月厦门大学附属第一医院收治的135例DF伴创面感染患者作为研究对象,采集患者感染创面分泌物标本并进行细菌培养、分离鉴定及药敏试验,分析DF患者感染创面的病原菌分布情况及耐药性。结果经检测,135例DF伴细菌感染患者共检出149株病原菌,其中革兰氏阴性菌(GNB)65株,占比43.62%(65/149),革兰氏阳性菌(GPB)73株,占比48.99%(73/149),真菌11株,占比7.38%(11/149)。药敏试验结果显示,GPB敏感性前三位分别为利奈唑胺、莫西沙星及万古霉素,耐药前三位分别为青霉素、苯唑西林及氨苄西林;GNB敏感性前三位分别为亚胺培南、美罗培南及阿莫西林/克拉维酸,耐药前三位分别为阿莫西林、替卡西林及头孢他啶。结论GPB及GNB是DF伴细菌感染创面分泌物的主要病原菌,且不同病原菌耐药性不同,应结合DF患者的病原菌情况,合理选用抗菌药物。Objective To investigate the distribution and drug resistance of pathogenic bacteria in infected wounds of patients with diabetic foot(DF).Methods A total of 135 patients with DF with wound infection treated in the First Affiliated Hospital of Xiamen University from May 2017 to April 2019 were selected.The samples of infected wound secretions were collected,and the bacterial culture,isolation and identification and drug sensitivity test were carried out.The distribution and drug resistance of pathogens in the infected wound of DF patients were analyzed.Results A total of 149 strains of pathogens were detected in 135 patients with DF with bacterial infection,including 65 strains of Gram-negative bacteria(GNB),accounting for 43.62%(65/149),73 strains of Gram-positive bacteria(GPB),accounting for 48.99%(73/149),and 11 strains of fungi,accounting for 7.38%(11/149).The results of drug sensitivity test showed that the top three of GPB sensitivity were Linezolid,Moxifloxacin and Vancomycin respectively,and the top three of drug resistance were Penicillin,Oxacillin and Ampicillin respectively;the top three of GNB sensitivity were Imipenem,Meropenem and Amoxicillin/Clavulanic Acid,and the top three of drug resistance were Amoxicillin,Ticarcillin and Ceftazidime.Conclusion GPB and GNB are the main pathogens of wound secretion of DF with bacterial infection,and different pathogens have different drug resistance.Antibiotics should be selected reasonably in combination with the pathogen situation of DF patients.

关 键 词：糖尿病足 病原菌 耐药性 革兰阳性菌 革兰阴性菌 

分 类 号：R587.1[医药卫生—内分泌]