CAJ | 학술논문

目的：了解糖尿病足感染患者的病原菌分布特点及耐药性，为临床合理选择抗菌药物提供参考。方法：收集2011年5月-2013年7月收治的50例糖尿病足患者，分析其足分泌物中分离的病原菌特点及耐药情况。结果：50例患者共采集63份标本，其中56份标本培养出病原菌，阳性率为88．9％，革兰氏阳性菌、革兰氏阴性菌、真菌分别为34株（60．7％）、17株（30．4％）、5株（8．9％），金黄色葡萄球菌、表皮葡萄球菌、奇异变形杆菌占前3位，以Wagner 2、3级患者为主（86．0％）。革兰氏阳性菌（主要是葡萄球菌属）对万古霉素、呋喃妥因敏感性高，而对青霉素、苯唑西林耐药性高。革兰氏阴性菌对亚胺培南、美洛培南、头孢三、四代敏感性高，对替卡西林、头孢一、二代耐药性高。在治疗过程中局部所感染的细菌种类及耐药性都有变化。结论：该组患者以浅部感染者为多，糖尿病足感染以金黄色葡萄球菌、表皮葡萄球菌、奇异变形杆菌占前3位，在治疗过程中要针对病原菌及药敏试验结果及时调整抗菌药物，以减少耐药性的产生。
목적：료해당뇨병족감염환자적병원균분포특점급내약성，위림상합리선택항균약물제공삼고。방법：수집2011년5월-2013년7월수치적50례당뇨병족환자，분석기족분비물중분리적병원균특점급내약정황。결과：50례환자공채집63빈표본，기중56빈표본배양출병원균，양성솔위88．9％，혁란씨양성균、혁란씨음성균、진균분별위34주（60．7％）、17주（30．4％）、5주（8．9％），금황색포도구균、표피포도구균、기이변형간균점전3위，이Wagner 2、3급환자위주（86．0％）。혁란씨양성균（주요시포도구균속）대만고매소、부남타인민감성고，이대청매소、분서서림내약성고。혁란씨음성균대아알배남、미락배남、두포삼、사대민감성고，대체잡서림、두포일、이대내약성고。재치료과정중국부소감염적세균충류급내약성도유변화。결론：해조환자이천부감염자위다，당뇨병족감염이금황색포도구균、표피포도구균、기이변형간균점전3위，재치료과정중요침대병원균급약민시험결과급시조정항균약물，이감소내약성적산생。
Objective :To study pathogenic bacteria distribution and antimicrobial resistance in diabetic foot infection patients ,and provid information for choosing effective antibacterials during treatment .Methods :50 diabetic foot patients were enrolled from May 2011 to July 2013 in our hospital .Pathogenic spectrum and antimicrobial resistance were con-ducted on the infection secretion from the groups .Results:63 secretion specimens were isolated from 50 patients .56 strains of pathogens were isolated ,positive rate was up to 88 .9% .Gram positive bacteria were thirty four strains (60.7% ,34/56) ,gram negative bacteria were seventeen strains (30 .4% ,17/56) and fungi were five strains(8 .9% ,5/56) .The major pathogens in the secretion were staphylococcus aureus ,saphylococcus epidermidis and proteus mirabi-lis .43 of 50 patients (86% ) were classified as Wagner’s grade two and three .The sensitive rate of gram positive bac-teria (staphylococcus) to vancocin ,furadantin was higher ,and the resistance rate of staphylococcus to benzylpenicillin , oxacillin was higher .The sensitive rate of gram-negative bacteria to imipenem ,meropenem ,the third and fourth genera-tion cephalosporins was higher ,and the resistance rates of gram-negative bacteria to ticarcillin ,generation of cephalo-sporins and the second generation cephalosporins was higher .During the course of treatment ,bacterial species and the sensitivity of the same species of bacteria changed .Conclusion:The major patients were the superficial infection group . The major pathogens of diabetic foot infection patients in our group were staphylococcus aureus ,staphylococcus epi-dermidis and proteus mirabilis . Regular microbial culture and antimicrobial susceptibility testing are necessary for choosing effective medication during treatment ,so the drug resistant pathogens will decrease .