摘要
目的探讨糖尿病足感染患者常见多药耐药菌和相关因素及对策。方法选取2014年1月-2015年12月医院收治的268例糖尿病足患者为研究对象,分别对糖尿病足感染患者的常见多药耐药菌和耐药情况及多药耐药菌感染的相关因素进行分析。结果 268例糖尿病足患者中发生多药耐药菌感染121例,感染率为45.15%。共培养分离多药耐药菌149株,其中革兰阴性菌75株占50.34%,以铜绿假单胞菌和大肠埃希菌为主;革兰阳性菌74株占49.66%,以金黄色葡萄球菌为主;革兰阴性菌对头孢哌酮表现出较高的耐药性,其耐药率在60.00%以上;对美罗培南和亚胺培南等较敏感;革兰阳性菌对红霉素表现出较高的耐药性,其耐药率为94.20%;对万古霉素、替考拉宁较敏感。糖尿病病程、每年因同一伤口住院次数、合并骨髓炎、神经缺血性伤口、既往使用抗菌药物是糖尿病足患者多药耐药菌感染的相关因素(P<0.05)。结论应根据具体耐药情况科学选择抗菌药物,并针对具有感染相关因素的患者采取积极的护理应对措施。
OBJECTIVE To probe into and analyze the distribution of common multidrug-resistant bacteria,risk factor and countermeasure of diabetic foot infection.METHODS A total of 268 cases of diabetic foot patients from Jan.2014 to Dec.2015 were selected as clinical subjects from the hospital.The distribution and drug resistance of common multidrug-resistant bacteria in patients with diabetic foot infection and the risk factores of infection were analyzed.RESULTS Totally 121 cases were with multidrug-resistant bacterial infection among 268 cases of diabetic foot patients,and the infection rate was45.15%.Totally 149 strains of multidrug-resistant bacteria were detected,of which 75 strains of gram-negative bacteria accounted for 50.34%,mainly Pseudomonas aeruginosaand Escherichia coli,and 74 strains of gram-positive bacteria accounted for 49.66%,mainly Staphylococcus aureus.The gram-negative bacteria showed higher resistance to cefoperazone,and the drug resistant rates were more than 60.00%,while they were sensitive to meropenem and imipenem.The gram-positive bacteria showed higher resistance to erythromycin,and the drug resistant rate was 94.20%,while they were sensitive to vancomycin and teicoplanin.The diabetes course,the number of hospitalization of the same wound every year,combined with osteomyelitis,neurotoxic wound,and the previous use of antimicrobial drugs were risk factors of diabetic foot patients with multidrug-resistant bacterial infection（P〈0.05）.CONCLUSION Antibiotics should be selected scientifically according to the specific drug resistance,and active nursing measures should be taken for patients with infection related factors.
作者
周玲丽
潘伟
杨浩瑾
沈雯
鲍丽青
黄倍倍
林周回
吴玲克
朱虹
ZHOU Ling-li;PAN Wei;YANG Hao-jin;SHEN Wen;BAO Li-qing;HUANG Bei-bei;LIN Zhou-hui;WU Ling-ke;ZHU Hong(The First Affiliated Hospital of Wenzhou Medical University, Wenzhou , Zhejiang 325015, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第12期1842-1845,共4页
Chinese Journal of Nosocomiology
基金
浙江省自然科学基金资助项目(LY17H070005)
关键词
糖尿病足
感染
多药耐药菌
对策
Diabetic foot
Infection
Multidrug-resistant bacteria
Countermeasure
