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  本文關(guān)鍵詞：基于Wagner分級糖尿病足感染的病原菌分布及藥敏分析　出處：《重慶醫(yī)科大學(xué)學(xué)報》2016年11期 　論文類型：期刊論文

  更多相關(guān)文章： 糖尿病足感染 Wagner分級 病原菌 多重耐藥 藥敏

【摘要】：目的:調(diào)查基于Wagner分級糖尿病足感染(diabetic foot infection,DFI)的病原菌分布及藥敏情況。方法:回顧性調(diào)查重慶醫(yī)科大學(xué)附屬第一醫(yī)院2014年1月至2016年1月收治的216例DFI患者,統(tǒng)計分析不同Wagner分級的DFI患者病足潰瘍標本中培養(yǎng)的病原菌分布、多重耐藥(multiple drug resistance,MDR)菌構(gòu)成及其藥敏結(jié)果。結(jié)果:分離出病原菌263株:單菌感染占57.4%,混合菌感染占42.6%;革蘭陽性(G+)菌、革蘭陰性(G-)菌和真菌分別占43.5%、48.1%和8.4%。Wagner分級患足細菌培養(yǎng)結(jié)果顯示:2級:G+菌45株,金黃色葡萄球菌占48.9%,G-菌43株,腸桿菌占69.8%;3級:G+菌36株,腸球菌占47.2%,金黃色葡萄球菌占27.8%,G-菌44株,腸桿菌占72.7%;4級:G+菌24株,腸球菌占33.3%,金黃色葡萄球菌占25.0%,鏈球菌占25.0%,G-菌23株,腸桿菌占73.9%;5級:G+菌9株,腸球菌占66.7%,G-菌16株,腸桿菌占81.3%。不同Wagner分級患者G+菌和G-菌分布情況無統(tǒng)計學(xué)差異(P=0.526)。G+菌對萬古霉素、利奈唑胺、莫西沙星、替加環(huán)素敏感性達75%以上,G-菌對碳青霉烯類、阿米卡星、抗假單胞菌青霉素類復(fù)方制劑、四代頭孢菌素類、頭霉素類敏感性達64%以上。結(jié)論:DFI患者總體上單一菌略多于混合菌感染,G-菌較G+菌感染分布略占優(yōu)勢。G+菌及G-菌對常用的抗G+菌及G-菌藥物有較好敏感性。
[Abstract]:Objective: to investigate diabetic foot infection based on Wagner classification. Methods: a retrospective study was conducted on 216 patients with DFI admitted to the first affiliated Hospital of Chongqing Medical University from January 2014 to January 2016. The distribution of pathogenic bacteria in the specimens of foot ulcers from patients with DFI with different Wagner grades was statistically analyzed, and multiple multidrug resistant drug resistance was obtained. Results: 263 strains of pathogenic bacteria were isolated: single bacteria infection accounted for 57.4%, mixed bacteria infection accounted for 42.6%; Gram-positive G), Gram-negative G) and fungi accounted for 43.5% respectively. The results of 48.1% and 8.4. Wagner's grading showed that 45 strains of G strain were in grade 2 and 43 strains were Staphylococcus aureus. Enterobacterium accounted for 69.8%; 36 strains of grade 3: G, 47.2% of Enterococcus, 27.8% of Staphylococcus aureus and 72.7% of Enterobacter; 24 strains of grade 4: G, 33.3% of Enterococcus, 25.0 of Staphylococcus aureus, 23 of Streptococcus sp., and 73.9 of Enterobacter; There were 9 strains of grade 5 G and 16 strains of Enterococcus. Enterobacterium accounted for 81.3. There was no statistical difference in the distribution of G and G- bacteria in patients with different Wagner grades. There was no significant difference in the distribution of G and G- bacteria against vancomycin, linazolamine and moxifloxacin. The sensitivity of tegicycline to carbapenem, amikacin, penicillin compound preparation and cephalosporins of four generations were more than 75%. The sensitivity of cephalomycin is more than 64%. Conclusion in general, the single bacteria is slightly more than mixed bacteria infection in the patients with head DFI. The distribution of G- bacteria was a little higher than that of G-bacteria. G and G-bacteria were more sensitive to G-resistant and G-bacteria drugs.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院藥學(xué)部;重慶醫(yī)科大學(xué)附屬第一醫(yī)院內(nèi)分泌科;
【分類號】：R587.2
【正文快照】： 糖尿病足病最常見的形式是足潰瘍,糖尿病患者發(fā)生足潰瘍的風(fēng)險高達25%[1]。我國多中心調(diào)查數(shù)據(jù)證實,糖尿病足潰瘍患者約有70%合并感染[2]。糖尿病足潰瘍感染的早期診斷和規(guī)范治療,不僅可提高抗感染療效、促進潰瘍愈合,也是保肢的基本措施和節(jié)省醫(yī)療費用的有效途徑。明確糖尿病

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