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Received:May 02, 2019 Published Online:January 20, 2020
Received:May 02, 2019 Published Online:January 20, 2020
中文摘要: 目的 探讨糖尿病足溃疡(DFU)感染的病原菌分布及药物敏感性,以期为临床正确选择抗菌药物治疗提供参考依据。
方法 收集2017年1月至2018年12月湖北医药学院附属襄阳市第一人民医院住院的95例DFU患者的临床资料,对其足部溃疡分泌物病原菌培养结果及药敏试验结果进行描述性分析。
结果 95例DFU患者共分离培养病原菌77株,其中革兰阳性菌(G+)43株(55.8%),革兰阴性菌(G-)30株(39.0%),真菌4株(5.2%)。G+菌以金黄色葡萄球菌、粪肠球菌及溶血性葡萄球菌为主;G-菌以大肠埃希菌、阴沟肠杆菌及铜绿假单胞菌为主。排在前三位的细菌分别为金黄色葡萄球菌、大肠埃希菌及阴沟肠杆菌,总占比58.4%。药敏分析显示,主要的G+菌对万古霉素、替考拉宁、利福平及利奈唑胺几乎全敏感,主要的G-性菌对美罗培南、亚胺培南、哌拉西林舒巴坦、头孢西丁敏感性高。
结论 该院DFU感染的病原菌以G+菌为主,前三位感染的细菌分别为金黄色葡萄球菌、大肠埃希菌及阴沟肠杆菌,故在未确定病原菌的情况下,可针对以上细菌使用抗菌药物,明确病原菌后再根据情况进行调整,以期早期正确使用抗菌药物、积极控制感染、改善患者预后。
Abstract:Objective To explore the distribution and drug sensitivity of pathogenic bacteria in diabetic foot ulcer infection to provide basis for the correct selection of clinical antimicrobial treatment.
Methods The clinical data of 95 patients with diabetic foot ulcer attending hospital from January 2017 to December 2018 was collected,and the descriptive analysis was made on the results of pathogen culture and drug sensitivity test from foot ulcer secretion.
Results There were 77 strains of bacteria from the secretions of 95 patients,including 43 strains (55.8%) gram positive bacteria(G+),30 strains(39.0%)gram negative bacteria (G-) and 4 strains (5.2%) of fungi.G+bacteria were mainly staphylococcus aureus,enterococcus faecalis and staphylococcus haemolyticus;G- bacteria were mainly escherichia coli,enterobacter cloacae and pseudomonas aeruginosa.The top three bacteria were staphylococcus aureus,escherichia coli and enterobacter cloacae,accounting for 58.4% of the total bacteria strains.Drug sensitivity testing showed that the main G+bacteria were sensitive to vancomycin,teicoplanin,rifampicin and linezolid,while the main G-bacteria were highly sensitive to meropenem,imipenem,piperacillin sulbactam and cefoxitin.
Conclusions The pathogens of diabetic foot ulcer infection are mainly G+ bacteria.Therefore,antibacterial drugs can be used for staphylococcus aureus,escherichia coli and enterobacter cloacae before the pathogenic bacteria are identified and can be adjusted after the pathogenic bacteria are determined so as to use antibacterial drugs in the early stage correctly,control infection actively and improve prognosis.
keywords: Diabetic foot ulcer Pathogenic bacteria Antibacterial drugs Drug sensitivity Gram positive bacteria Gram negative bacteria
文章编号: 中图分类号: 文献标志码:B
基金项目:湖北省教育厅科学技术研究项目(B2014051)
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