CAJ | 학술논문

目的分析糖尿病足感染病原菌分布与足溃疡病情严重性的关系,探讨病原菌分布特点和合理治疗选择.方法 90份微生物培养阳性的糖尿病足溃疡感染结果,按照足溃疡病情分Wagner 1-5级、感染程度分为轻中重度,统计菌科、菌属、菌种,分析病原菌分布与足溃疡严重性、感染程度等的关系.结果随着糖尿病足溃疡Wagner级别增加、感染程度加重,病原菌谱由以革兰阳性球菌为主(Wagner 1级61.1％)转变为以革兰阴性杆菌为主(Wagner 5级80.0％),同时混合感染(10.0％ - 28.6％)、条件致病菌感染增加(83.3％ - 100％),以革兰阴性杆菌为主的条件致病菌混合感染增加.Wagner分级、感染程度、曾治疗病史及年龄、血糖控制情况、足溃疡病程等共同影响感染类型和病原菌类型(P＜0.05).结论糖尿病足溃疡病情重、感染重的患者,以革兰阴性杆菌为主的条件致病菌为主的混合感染比例增加,提示临床需针对件应用抗生素.
목적 분석당뇨병족감염병원균분포여족궤양병정엄중성적관계,탐토병원균분포특점화합리치료선택.방법 90빈미생물배양양성적당뇨병족궤양감염결과,안조족궤양병정분Wagner 1-5급、감염정도분위경중중도,통계균과、균속、균충,분석병원균분포여족궤양엄중성、감염정도등적관계.결과 수착당뇨병족궤양Wagner급별증가、감염정도가중,병원균보유이혁란양성구균위주(Wagner 1급61.1％)전변위이혁란음성간균위주(Wagner 5급80.0％),동시혼합감염(10.0％ - 28.6％)、조건치병균감염증가(83.3％ - 100％),이혁란음성간균위주적조건치병균혼합감염증가.Wagner분급、감염정도、증치료병사급년령、혈당공제정황、족궤양병정등공동영향감염류형화병원균류형(P＜0.05).결론 당뇨병족궤양병정중、감염중적환자,이혁란음성간균위주적조건치병균위주적혼합감염비례증가,제시림상수침대건응용항생소.
Objective To explore the distribution of pathogenic micro-organisms in the diabetic patients with foot infection,and to investigate the characteristics of the pathogen distribution and its relationship with the severity of diabetic foot ulcer( DFU ).Methods Ninety diabetic foot patients with positive culture of micro-organisms were classified into Wagner 1-5 grades according to the severity of DFU,which was ranked as mild,moderate,and severe infection based on the gradient of infection.The family,genus,and strain of micro-organisms were analyzed,and associated factors were discussed in regard to the kinds and severity of DFU and infection.Results With rising Wagner's grades and aggravating infection,the bacterial floras were transformed from gram-positive cocci( 61.1％ in Wagner 1 ) to gram-negative rods( 80.0％ in Wagner 5),at the same time,composite( 10.0％ to 28.6％ ) and opportunist ( 83.3％ to 100％ ) infections were increased.Wagner's grade,severity of infection,previous treatment,patients' age,control of blood glucose,course of DFU,etc,were all related to types of infection and opportunist infection ( P＜0.05 ).Conclusions Proportion of gram-negative bacilli with opportunist composite infection seems to increase in patients with severe DFU and severe infection requiring appropriate application of antibiotics.