糖尿病足微生物群落多样性和病原学耐药性实验研究  

Experimental study of microbial community diversity and pathogenic drug resistance in patients with diabetic foot

作　　者：毛敏婕 金凤鸣 王蔚 周强 沈彬彬 吕火烊[4] MAO Min-jie;JIN Feng-ming;WANG Wei;ZHOU Qiang;SHEN Bin-bin;LV Huo-yang(不详;Department of Laboratory,the First Hospital of Jiaxing,Zhejiang 314001,China)

机构地区：[1]嘉兴市第一医院检验科,浙江314001 [2]嘉兴市第一医院普外科 [3]嘉兴市第一医院内分泌科 [4]浙江省人民医院检验中心

出　　处：《中国卫生检验杂志》2023年第13期1554-1559,共6页Chinese Journal of Health Laboratory Technology

基　　金：嘉兴市第一医院医学重点学科(2020YJZD012,2023-ZC-002)。

摘　　要：目的分析168例糖尿病足病原学,统计混合感染率、主要菌种及耐药率,对比分析16S rDNA和传统培养菌群检出差异。方法采用WHONET 5.6软件进行数据分析,16S rDNA检测菌株病原学构成。结果传统培养法检出病原菌311株,阳性率为83.13%。单一感染为49.80%,双重感染为28.23%。检出革兰阳性球菌占45.02%,革兰阴性杆菌占43.41%,真菌占5.79%,专性厌氧菌占1.28%。革兰阳性球菌以金黄色葡萄球菌、无乳链球菌、粪肠球菌为主。革兰阴性杆菌主要为变形杆菌、肺炎克雷伯菌、大肠埃希菌。革兰阳性球菌对万古霉素、利奈唑胺、替加环素药均敏感。革兰阴性杆菌对碳青霉烯类、氨基糖苷类、β-内酰胺酶抑制剂复方制剂较敏感。随机选取11例送检16S rDNA测序,获得301种OTUs。门水平上,以厚壁菌门、变形菌门、拟杆菌门为主。属水平上,以葡萄球菌属、消化链球菌属、厌氧球菌为主。结论糖尿病足感染病原菌种类多,金黄色葡萄球菌最常见,存在多重感染、混合感染和厌氧菌感染。2种方法学菌群差异较大,16S rDNA敏感性高,传统培养可能漏检厌氧菌。Objective This paper aims to analyze the etiological characteristics of 168 cases of diabetic foot,the mixed infec⁃tion rate,the main strains and the drug resistance rate,and the difference between 16S rDNA and traditional culture bacteria.Methods WHONET 5.6 software was used for data analysis,and 16S rDNA was used to detect the pathogen composition of the strain.Results A total of 311 strains of pathogenic bacteria were detected by traditional culture,with a positive rate of 83.13%.Single infection was 49.80%and dual infection was 28.23%.Gram-positive cocci accounted for 45.02%,Gram-negative bacilli accounted for 43.41%,Fungi accounted for 5.79%and Obligate anaerobes accounted for 1.28%.Gram posi⁃tive cocci were mainly Staphylococcus aureus,Streptococcus agalactias and Enterococcus faecalis.Gram negative bacilli are main⁃ly Proteus,Klebsiella pneumoniae,Escherichia coli.Gram positive cocci were sensitive to vancomycin,linezolid and tigecycline.Gram negative bacilli showed higher sensitivity to carbapenems,aminoglycosides,β-lactamase inhibitor compound prepara⁃tion.11 samples were randomly selected for the sequencing of 16S rDNA,and 301 OTUs were obtained.At the level of phylum,Firmicutes,Proteus,and Bacteroides were the main bacteria.At the genus level,Staphylococcus,Digestive Streptococ⁃cus,and Anaerococcus were the dominant.Conclusion There are many kinds of pathogenic bacteria of diabetic foot infection,with Staphylococcus aureus the dominant,and there are multiple infection,mixed infection and anaerobic infection.The bacterial community of the two methods is different,and the 16S rDNA shows high sensitivity.The traditional culture method may miss the detection of anaerobic bacteria.

关 键 词：糖尿病足 病原菌 多样性 多重感染 药物敏感性 

分 类 号：R587.2[医药卫生—内分泌]