摘要
目的分析糖尿病足患者的病原菌分布特点、药敏结果及治疗过程中的病原菌变化规律,为临床治疗糖尿病足合理选择抗菌药物提供依据。方法回顾性分析2008年7月至2010年2月收治的116例糖尿病足患者的临床资料,细菌鉴定和药敏试验采用法国Bio-Merieux公司的VITEK AMS-60全自动微生物系统GPI细菌鉴定卡,药敏试验采用kirby-Bauer法。结果116例患者共采集168份标本,其中120份标本培养出病原菌,阳性率71.4%,球菌、杆菌、真菌分别为43%、45%、12%,粪肠球菌、金黄色葡萄球菌、铜绿假单胞菌占前3位;混合感染占33%,以WagnerⅢ～Ⅴ级患者为主。粪肠球菌对青霉素、氨苄西林敏感性最高,葡萄球菌对万古霉素、头孢西汀敏感性最高,铜绿假单胞菌对哌拉西林/三唑巴坦、头孢哌酮/舒巴坦、左氧氟沙星、美罗培南敏感性最高。本组患者铜绿假单胞菌对亚胺培南的耐药达50%;在治疗过程中同一部位的细菌种类会有变化,同一部位同种细菌的耐药性也有变化。结论糖尿病足感染以粪肠球菌、金黄色葡萄球菌、铜绿假单胞菌占前3位,混合感染占33%,对于重症患者要首选广谱抗生素,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,尽量减少耐药性的产生。
Objective By analyzing the pathogen profile of 116 cases of diabetic foot,the antimicrobial susceptibility to antimicrobial agents,to guide the changes of the treatment and provide the basis for rational choice of clinical antimicrobial agents.Methods Bacterial identification and susceptibility were tested by Bio-Merieux,France＇s VITEK AMS-60 automatic microbial systems d GPI bacteria identification card and the kirby-Bauer susceptibility test method.Results 148 samples were collected in which 120 samples reveal pathogen growth.The positive rate was 71.4%.The cocci,bacilli and fungi accounted for 43%,45%,12%,respectly.Enterococcus faecalis,staphylococcus aureus and pseudomonas aeruginosa were the major aerobicbacteria.Mixed infections accounted for 33%.The sensitivity of enterococcus faecalis to penicillin,ampicillin was the highest.The sensitivity of staphylococcus aureus to vancomycin,imipenem,ceftazidime was high.The sensitivity of pseudomonas aeruginosa to piperacillin / tazobactam,cefoperazone / Shu Batan was high.Among this group of cases,the resistant rate of pseudomonas aeruginosa to imipenem was up to 50%.During the course of treatment,bacterial species in the same area changed and the sensitivity of the same species of bacteria in the same area could be different.Conclusions The diabetic foot is frequently associated infections with enterococcus faecalis,staphylococcus aureus,pseudomonas aeruginosa infection.Rational choice of antimicrobial agents should be directed the targel of the pathogen.
出处
《北京医学》
CAS
2010年第5期383-386,共4页
Beijing Medical Journal
关键词
糖尿病足
细菌学
抗菌药物
药物敏感性试验
Diabetic foot Bacteria Anti-bacteria drug Antibiotic susceptibility test
