糖尿病足患者多药耐药菌感染病原学及其影响因素  

Etiological characteristics and influencing factors for multidrug-resistant bacteria infection in diabetic foot patients

作　　者：邓飞[1] 沈亚非[1] 常红娟 DENG Fei;SHEN Ya-fei;CHANG Hong-juan(Luohe Central Hospital(The First Affiliated Hospital of Luohe Medical College),Luohe,Henan 462000,China;不详)

机构地区：[1]漯河市中心医院(漯河医专一附院)内分泌代谢科,河南漯河462000 [2]武汉科技大学医学院,湖北武汉430081

出　　处：《中华医院感染学杂志》2023年第15期2300-2304,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划项目(LHGJ20200896)。

摘　　要：目的 调查糖尿病足患者多药耐药菌感染病原学特点、影响因素及管理措施。方法 回顾性收集2019年1月-2022年1月漯河市中心医院收治的糖尿病足且分泌物病原学检测阳性患者136例临床资料,根据病原学检测结果分为多药耐药菌感染组(n=42)、非多药耐药菌感染组(n=94)。分析糖尿病足患者多药耐药菌感染病原学特征,通过单因素、多因素分析糖尿病足患者多药耐药菌感染的影响因素。结果 42例糖尿病足患者共分离出多药耐药菌57株,其中革兰阴性菌38株,革兰阳性菌19株,占比分别为66.67%、33.33%;多因素Logistic分析结果显示,糖尿病病程≥15年、Wagner分级4~5级、合并骨髓炎、25-羟基维生素D[25(OH)D]<30 ng/ml、血浆黏度(PV)≥1.5 mPa·s为糖尿病足患者多药耐药菌感染的影响因素(P<0.05)。结论 糖尿病足患者多药耐药菌感染主要病原菌为革兰阴性菌,多种因素均可导致糖尿病足患者多药耐药菌感染的发生,临床可据此制定管理措施进行针对性干预,进而预防糖尿病足患者多药耐药菌感染,改善患者预后。OBJECTIVE To investigate the etiological characteristics,susceptibility factors and management measures of multi-drug resistant bacteria infection in patients with diabetic foot.METHODS The clinical data of 136 patients with diabetic foot who tested positive for multi-drug resistant bacteria from secretions were retrospectively collected in Luohe Central Hospital from Jan 2019 to Jan 2022.The etiological characteristics of multidrug-resistant bacterial infection in patients with diabetic foot were analyzed,and the susceptibility factors for the infection were analyzed by univariate and multivariate factors.RESULTS A total of 57 strains of multidrug-resistant bacteria were isolated from 42 patients with diabetic foot,among which 38 strains were gram-negative and 19 strains were gram-positive,accounting for 66.67%and 33.33%,respectively.Multivariate logistic analysis showed that diabetes duration≥15 years,Wagner grade 4-5,osteomyelitis,25-hydroxyvitamin D[25(OH)D]<30 ng/ml,plasma viscosity(PV)≥1.5 mPa·s were the risk factor for multidrug-resistant bacterial infection in patients with diabetic foot(P<O.05).CONCLUSION The main pathogens of multidrug-resistant bacteria infection in diabetic foot patients were gram-negative bacteria,and various factors can affect multidrug-resistant bacteria infection in diabetic foot patients.Clinical management measures should be developed and targeted interventions can be carried out to prevent multi-drug resistant bacteria infection in diabetic foot patients,in order to improve the prognosisof patients.

关 键 词：糖尿病足 多药耐药菌 病原学 影响因素 管理措施 

分 类 号：R587.2[医药卫生—内分泌]