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目的分析糖尿病足溃面处病原菌分布及耐药性变迁,为临床合理使用抗菌药物提供依据。方法回顾性分析2014~2016年在某院住院的93例糖尿病足感染患者分泌物中分离的99株病原菌及3年耐药性的变迁。结果糖尿病足患者感染的病原体中,细菌感染占95.9%,真菌占4.1%。细菌性病原菌中,革兰氏阳性菌感染占31.3%,以葡萄球菌多见,但耐甲氧西林金黄色葡萄球菌(MRSA)及耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的发生率逐年下降,未见对万古霉素耐药的革兰氏阳性球菌;革兰氏阴性菌占64.6%,且占比逐渐上升,分布以肠杆菌科细菌为主,其次为铜绿假单胞菌,对常用抗菌药物耐药率逐年升高;真菌感染以混合感染形式出现,呈逐年下降趋势。结论对糖尿病足感染病原菌及其耐药性进行监测,可为防治糖尿病足感染提供用药依据,合理使用抗菌药物。
Objective To analyze the distribution of pathogens and the changes of drug resistance in the diabetic foot ulcers and provide the basis for the rational use of antibacterials in clinic. Methods Ninety-nine pathogenic bacteria isolated from secretions of 93 patients with diabetic foot infection in a hospital from 2014 to 2016 were retrospectively analyzed. The changes of 3-year drug resistance were retrospectively analyzed. Results Among the pathogens infected with diabetic foot, bacterial infection accounted for 95.9% and fungi accounted for 4.1%. Gram-positive bacterial infections accounted for 31.3% of all bacterial pathogens, most of which were staphylococci. However, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCNS) Decreased, there was no vancomycin-resistant gram-positive cocci; Gram-negative bacteria accounted for 64.6%, and the proportion increased gradually, the distribution of Enterobacteriaceae bacteria, followed by Pseudomonas aeruginosa, Commonly used antimicrobial resistance rates increased year by year; fungal infections in the form of mixed infection, showed a downward trend year by year. Conclusion The monitoring of diabetic foot infection pathogens and their drug resistance may provide a basis for the prevention and treatment of diabetic foot infections, rational use of antimicrobial agents.