糖尿病足感染病原菌分析

刘阳张婉黄超胡玲玲

(华北理工大学附属医院河北唐山063000)

[摘要]①目的探讨糖尿病足感染的主要病原菌分布状况及防治方法。②方法我院住院的糖尿病足感染患者108例,选取患者足部溃疡部位的分泌物,置于无菌试管内送检,对培养出的所有病原菌情况及分布耐药性进行分析。③结果108例患足部分泌物培养阳性68例, 阳性率为63.0%,共分离出病原菌68株,其中革兰阴性菌(G-)40株，占57.1%；革兰阳性菌(G+)22株，占31.4%；真菌6例，占8.5%。G-多以铜绿假单胞菌、大肠杆菌常见，G+以金黄色葡萄球菌、肠球菌居多。耐药性分析结果G-对万古霉素及阿米卡星的耐药率较低，G+对万古霉素和头孢类药物的耐药率较低。④结论糖尿病足感染的病原菌种类繁多且对抗生素耐药情况严重,糖尿病足发生耐药菌感染与多种因素有密切的关系,临床应根据耐药菌检测结果合理用药并选取合适的防治方法,重在预防危险因素。

[关键词]耐药菌感染糖尿病足危险因素

[中图分类号]R 57[文献标识码]A

【作者简介】刘阳(1973-)，男，副主任医师。研究方向：皮肤性病。

Analysis of pathogenic bacteria in diabetic foot infectionLIUYang,ZHANGWan,HUANGChao,etal(AffiliatedhospitalofNorthChinaUniversityofscienceandtechnology,Tangshan063000,China)

ABSTRACT[]ObjectiveTo investigate the distribution of major infectious bacteria in diabetic foot and its control method.Methods108 cases of diabetic foot infection in North China University of science and technology affiliated hospital,secretions of the patients with foot ulcer site selection and placed in a sterile test tube,can be submitted,to cultivate all drug resistance of the pathogenic bacteria distribution analysis and find a better prevention and cure method.ResultsIn 108 patients,the positive rate was 68 cases,the positive rate was 63%,68 strains of pathogenic bacteria were isolated,including 40 strains of gram negative bacteria(G-),22 strains of gram positive bacteria(G+),31.4%,G-,G+,G+,G-,8.5%,6,57.1%.ConclusionThere is a wide variety of pathogenic bacteria in diabetic foot infection,and the antibiotic resistance is serious.The infection of drug resistant bacteria in diabetic foot is closely related with many factors.The clinical application should be based on the results of drug resistant bacteria, and select the appropriate prevention and control method.

[KEYWORDS]Drug resistant bacteria infection.Diabetic foot.Risk factors Probucol

糖尿病足(diabeticfoot)是导致糖尿病患者发生截肢致残的主要原因之一，是糖尿病患者长期血糖控制不良，发生神经病变及不同程度末梢血管病变而出现下肢感染、溃疡形成和/或深部组织的破坏现象。国内外研究显示，约有23.0%可能出现糖尿病足溃疡，约50%以上患者发生感染[1]，因感染控制不佳而截肢约占20%[2]。因此，寻求合理抗生素治疗方案及防治方法,对改善糖尿病足预后具有重要的临床价值和社会意义[3,4]。……