山西医药杂志
山西醫藥雜誌
산서의약잡지
SHANXI MEDICAL JOURNAL
2014年
19期
2264-2266
,共3页
糖尿病足%感染%细菌%药物耐受性
糖尿病足%感染%細菌%藥物耐受性
당뇨병족%감염%세균%약물내수성
Diabetic foot%Infection%Bacteria%Drug tolerance
目的：分析糖尿病足患者感染常见病原菌分布及耐药情况，指导临床合理用药。方法回顾性调查分析我院收治的83例糖尿病足感染患者创面分泌物病原菌分离培养及其耐药状况。结果83例糖尿病足感染患者70例培养出病原菌，占84％（70/83），13例未见细菌生长，占16％（13/83）。共培养出病原菌82株，其中革兰阳性菌42株（51％），以葡萄球菌属最为多见；革兰阴性菌39株（48％），其中以肠杆菌科细菌最为多见，真菌1株（1％）。革兰阳性菌中多重耐药菌株比例较高，占33％；革兰阴性菌中多重耐药菌株较少，占10％。革兰阳性菌对万古霉素、利奈唑烷、氯霉素、利福平、庆大霉素、四环素类抗菌药较敏感，对青霉素、红霉素、克林霉素有一定的耐药性。革兰阴性菌对亚胺培南、氨基糖苷类、β-内酰胺酶及第2、3代头孢菌素类较敏感，对青霉素及第1代头孢菌素类耐药性高。结论糖尿病足患者感染病原菌分布广泛，应及时多次对糖尿病足感染进行创面细菌培养及药物敏感性试验，及时调整抗菌药物，减少耐药菌的产生，以利于促进创面早期愈合，降低糖尿病足截肢（趾）率。
目的：分析糖尿病足患者感染常見病原菌分佈及耐藥情況，指導臨床閤理用藥。方法迴顧性調查分析我院收治的83例糖尿病足感染患者創麵分泌物病原菌分離培養及其耐藥狀況。結果83例糖尿病足感染患者70例培養齣病原菌，佔84％（70/83），13例未見細菌生長，佔16％（13/83）。共培養齣病原菌82株，其中革蘭暘性菌42株（51％），以葡萄毬菌屬最為多見；革蘭陰性菌39株（48％），其中以腸桿菌科細菌最為多見，真菌1株（1％）。革蘭暘性菌中多重耐藥菌株比例較高，佔33％；革蘭陰性菌中多重耐藥菌株較少，佔10％。革蘭暘性菌對萬古黴素、利奈唑烷、氯黴素、利福平、慶大黴素、四環素類抗菌藥較敏感，對青黴素、紅黴素、剋林黴素有一定的耐藥性。革蘭陰性菌對亞胺培南、氨基糖苷類、β-內酰胺酶及第2、3代頭孢菌素類較敏感，對青黴素及第1代頭孢菌素類耐藥性高。結論糖尿病足患者感染病原菌分佈廣汎，應及時多次對糖尿病足感染進行創麵細菌培養及藥物敏感性試驗，及時調整抗菌藥物，減少耐藥菌的產生，以利于促進創麵早期愈閤，降低糖尿病足截肢（趾）率。
목적：분석당뇨병족환자감염상견병원균분포급내약정황，지도림상합리용약。방법회고성조사분석아원수치적83례당뇨병족감염환자창면분비물병원균분리배양급기내약상황。결과83례당뇨병족감염환자70례배양출병원균，점84％（70/83），13례미견세균생장，점16％（13/83）。공배양출병원균82주，기중혁란양성균42주（51％），이포도구균속최위다견；혁란음성균39주（48％），기중이장간균과세균최위다견，진균1주（1％）。혁란양성균중다중내약균주비례교고，점33％；혁란음성균중다중내약균주교소，점10％。혁란양성균대만고매소、리내서완、록매소、리복평、경대매소、사배소류항균약교민감，대청매소、홍매소、극림매소유일정적내약성。혁란음성균대아알배남、안기당감류、β-내선알매급제2、3대두포균소류교민감，대청매소급제1대두포균소류내약성고。결론당뇨병족환자감염병원균분포엄범，응급시다차대당뇨병족감염진행창면세균배양급약물민감성시험，급시조정항균약물，감소내약균적산생，이리우촉진창면조기유합，강저당뇨병족절지（지）솔。
Objective To analyze the spectrum and drug-resistance of pathogenic bacteria isolated from pa-tients with diabetic foot to instruct application of the antibiotics reasonably .Methods Isolated strains and their drug resistance from 83 patients with infected diabetic foot were retrospectively studied in our hospital .Results Eighty-two strains were isolated from 83 patients with diabetic foot .Seventy cases with bacterial growth ,account-ing for 84% ;13 cases no bacterial growth ,accounting for 16% .In 82 strains ,Gram-positive strains were 42 str-atins (51% ) ,in which staphylococcus aureus were most common ,Gram-negative strains were 39 stratins (48% ) , in which enterobacteriaceae were most common ,fungi strains was 1 stratins (1% ) .Multidrug-resistant strains were more higher in gram positive bacteria (33% ) than in gram negative bacteria(10% ) .Gram positive bacteria is sensitive to vancomycin ,linezolid ,chloramphenicol ,rifampicin ,gentamicin and tetracycline antibiotic ,but it has drug-resistance to penicillin ,erythromycin ,clindamycin .Gram negative bacteria is sensitive to Imipenem ,amin-oglycosides ,beta lactamase ,the 2nd ,3th generation cephalosporins ,but it has drug-resistance to Penicillin and the first generation cephalosporins .Conclusion Distribution of pathogenic bacteria in patients with diabetic foot infec-tion is wide .Pathogenic bacteria and its drug resistance should be timely and repeatedly monitored to adjust antibi-otics and reduce the generation of antibiotic resistant bacteria ,in order to promote wound healing of diabetes and reduce foot amputation (toe) rate .
