糖尿病足溃疡患者细菌感染特点及耐药影响因素分析  

Analysis of bacterial infection characteristics and influencing factors of multi-drug resistant bacteria in patients with diabetic foot ulcer

作　　者：谷宏伟[1] 李希娜[1] 魏华[1] 孙嘉良 李成博 海鑫 GU Hong-wei;LI Xi-na;WEI Hua;SUN Jia-liang;LI Cheng-bo;HAI Xin(Department of Pharmacy,the First Affiliated Hospital of Harbin Medical University,Haerbin 150007,China)

机构地区：[1]哈尔滨医科大学附属第一医院药学部,哈尔滨150007

出　　处：《临床药物治疗杂志》2022年第11期76-79,共4页Clinical Medication Journal

基　　金：黑龙江省卫生厅课题项目(2019-018)。

摘　　要：目的分析糖尿病足溃疡(DFU)患者细菌感染特点及发生多重耐药菌(MDRO)感染的影响因素。方法回顾性分析哈尔滨医科大学附属第一医院收治的DFU患者临床资料、足感染情况及其药敏试验结果。根据药物敏感试验结果将细菌感染阳性患者分为MDRO组和非MDRO组。分析其病原菌分布及耐药情况的特点,并且对DFU患者发生MDRO感染的影响因素进行分析。结果105例DFU患者培养出119细菌菌株,其中检出MDRO 70株。不同年龄、糖尿病并发症病程、足溃疡时间、抗菌药物联合使用情况以及反复感染情况的患者发生MDRO感染的情况不同,差异有统计学意义(P<0.05)。其中糖尿病并发症病程(OR=0.894,95%CI:0.822~0.973)、足溃疡时间(OR=0.297,95%CI:0.110~0.803)、抗菌药物联合使用情况(OR=0.366,95%CI:0.142~0.946)以及是否是反复感染(OR=0.375,95%CI:0.147~0.956)是DFU患者发生MDRO感染的影响因素(P<0.05)。结论该院DFU患者细菌感染严重,并且出现MDRO感染。不同因素对发生多重耐药情况的影响不同。Objective To analyze the characteristics of bacterial infection in patients with diabetic foot ulcer(DFU)and the influencing factors of multi-drug resistant organisms(MDRO)infection.Methods The clinical data,foot infection and drug sensitivity test results of patients with DFU admitted to the First Affiliated Hospital of Harbin Medical University were retro⁃spectively analyzed.According to the results of the drug sensitivity test,the bacterial infection positive group was divided into the MDRO group and non-MDRO group.To analyze the distribution of pathogenic bacteria and the characteristics of drug re⁃sistance,and the factors of MDRO infection in patients with DFU.Results Totally 119 bacterial strains were cultured from 105 DFU patients,70 of which were MDRO.The incidence of multidrug resistance infection was different in patients of different ages,the course of diabetes complications,the time of foot ulcer,the combined use of antibiotics and repeated infection(P<0.05).Among them,the course of diabetic complications(OR=0.894,95%CI:0.822 to 0.973),duration of foot ulcers(OR=0.297,95%CI:0.110 to 0.803),combination use of antibiotics(OR=0.366,95%CI:0.142 to 0.946),and whether it is recur⁃rent infection(OR=0.375,95%CI:0.147 to 0.956)were the influencing factors for MDRO in DFU(P<0.05).Conclusion Staphylococcus aureus was the main bacteria in diabetic foot infection and drug resistance in the hospital,and the drug resis⁃tance was serious.

关 键 词：多重耐药 糖尿病足溃疡 细菌 

分 类 号：R969.3[医药卫生—药理学] R587.2[医药卫生—药学] R446.5