糖尿病足患者的病原菌分布和抗菌药物的合理选择  

Distribution of Pathogenic Bacteria and Rational Selection of Antibacterial Drugs in Diabetic Foot Patients

作　　者：张玉红[1] ZHANG Yuhong(Department of Infection Management,Jianyang People's Hospital,Jianyang,Sichuan Province,641400 China)

机构地区：[1]四川省简阳市人民医院感染管理部,四川简阳641400

出　　处：《糖尿病新世界》2023年第3期186-189,共4页Diabetes New World Magazine

摘　　要：目的探讨糖尿病足患者的病原菌分布以及合理选择抗菌药物对其的作用。方法回顾性选取2020年2月—2021年2月四川省简阳市人民医院糖尿病足患者268例,分析268例患者的病原菌分布情况,并分析主要病原菌对抗菌药物的敏感性。结果268例患者检出病原菌284株,其中革兰氏阳性菌134株,检出率为47.18%,主要为金黄色葡萄球菌,占31.69%;其次为粪肠球菌,占9.15%;再次为表皮葡萄球菌,占3.52%;最后为无乳链球菌、溶血性葡萄球菌,均占1.41%。革兰氏阴性菌118株,检出率为41.55%,主要为大肠埃希菌,占19.72%;其次为铜绿假单胞菌,占11.98%;再次为肺炎克雷伯菌,占6.34%;最后为阴沟肠杆菌、奇异变形杆菌,分别占2.11%、1.41%。真菌32株,检出率为11.27%,主要为白假丝酵母菌,占7.75%;其次为光滑假丝酵母菌,占2.11%;最后为热带假丝酵母菌,占1.41%。主要革兰氏阳性菌对万古霉素、替加环素的敏感性最高,均为100.00%。粪肠球菌对青霉素G的敏感性最低,为0.00%。大肠埃希菌对厄他培南的敏感性最高,为94.64%;对环丙沙星的敏感性最低,为28.57%。铜绿假单胞菌对阿米卡星敏感性最高,97.06%,其次为哌拉西林-他唑巴坦的敏感性,为82.35%;对头孢西丁、头孢噻肟的敏感性最低,均为23.53%。肺炎克雷伯菌对厄他培南的敏感性最高,为88.89%;对头孢西丁、头孢他啶、头孢哌酮的敏感性最低,均为33.33%。结论糖尿病足患者的病原菌主要为金黄色葡萄球菌,分析糖尿病足患者菌群对抗菌药物的敏感性,能够有效指导临床合理选择药物。Objective To explore the distribution of pathogenic bacteria in patients with diabetic foot and reasonable selection of drugs for their effects.Methods 268 cases of diabetic foot patients from February 2020 to February 2021 in Jianyang People's Hospital,Sichuan Province were retrospectively selected.The distribution of pathogenic bacteria in 268 patients was analyzed,and the sensitivity of major pathogenic bacteria to antimicrobial drugs was analyzed.Results 284 pathogenic bacteria were detected in 268 patients,including 134 Gram-positive bacteria,with a detection rate of 47.18%,mainly Staphylococcus aureus,accounting for 31.69%.This was followed by Enterococcus faecalis,accounting for 9.15%.Again,it was Staphylococcus epidermidis,accounting for 3.52%.The last were nonlactating streptococci and hemolytic staphylococci,both accounting for 1.41%.Gram-negative bacteria 118 strains,the detection rate of 41.55%,mainly Escherichia coli,accounting for 19.72%.Followed by Pseudomonas aeruginosa,accounting for 11.98%.Again for Klebsiella pneumoniae,accounting for 6.34%.Lastly,Enterobacter cloacae and Proteus mirabilis,accounting for 2.11%and 1.41%,respectively.The fungal 32 strains,with a detection rate of 11.27%,were mainly Pseudomonas albicans,accounting for 7.75%,followed by Pseudomonas smoothus,accounting for 2.11%.The last was Pseudomonas tropicalis,accounting for 1.41%.The major gram-positive bacteria had the highest sensitivity to vancomycin and tigecycline,both at 100.00%.Enterococcus faecalis had the lowest susceptibility to penicillin G with 0.00%.Escherichia coli had the highest susceptibility to ertapenem with 94.64%.The lowest susceptibility to ciprofloxacin was 28.57%.Pseudomonas aeruginosa had the highest susceptibility to amikacin at 97.06%.The next highest susceptibility was for piperacillin-tazobactam with 82.35%.The lowest susceptibility to cefoxitin and cefotaxime were 23.53%.Klebsiella pneumoniae had the highest susceptibility to ertapenem with 88.89%.The lowest susceptibility to cefoxitin,ceftazidime

关 键 词：糖尿病足 病原菌 抗菌药物 敏感性 

分 类 号：R587.1[医药卫生—内分泌]