糖尿病足的病原体分布及其耐药性分析.docVIP

维普资讯htp:/wwweqvipcom ·142 · · 用 药 指 导 · 糖尿病足的病原体分布及其耐药性分析 金华伟，朱麒钱，吴东东，斯徐伟，官莉莉，俞钟明，楼大钧 【摘要】 目的 探讨本地区糖尿病足感染病原体分布及其耐药性，为临床合理应用抗菌药物提供依据。方法 对糖尿病足感染患者的创面分泌物进行细菌和真菌培养，用K-B 法或稀释法行药敏试验。结果 95例糖尿病足感染 分泌物标本中69例(72.6%)培养出病原体，分离出病原体106株，其中革兰阳性菌51株(占48.1%),革兰阴性 菌50株(占47.2%),真菌5株(占4.7%);产超广谱β - 内酰胺酶 (ESBLs) 的细菌15株，占肠杆菌科细菌的 34.1%。糖尿病足感染以凝固酶阴性葡萄球菌、金黄色葡萄球菌、变形杆菌和大肠埃希菌为主，也可见真菌感染。药 敏试验结果提示多重交叉耐药，革兰阴性菌对亚胺培南及加β-内酰胺酶抑制剂的抗菌药物较为敏感，革兰阳性菌对 万古霉素、氯霉素及头孢菌素较敏感；大肠埃希菌对常用抗菌药物均有耐药；凝固酶阴性葡萄球菌和肠球菌除万古霉 素外，对其他临床常用抗菌药物也均有耐药性。结论 糖尿病足感染的病原体分布广泛，对抗菌药物耐药率高，应选 择广谱抗菌药物联合用药。 【关键词】 糖尿病足；细菌感染和真菌病；抗菌药；抗药性 【中图分类号】 R587.23 【文献标识码】 A 【文章编号】1007-9572(2008)1B-0142-03 Distribution and Drug Resistance of Pathogenic Bacteria in Patients with Diabetic Foot JIN Hua - wei,ZHU Qi -qian, WU Dong - dong,et al. Department of Endocrinology,Peoples Hospital of Shaotin,Shaoring 312000,China 【Abstract] Objective To study the distribution and drug resistance of pathogenic bacteria in patients with diabetic foot to provide a basis for reasonable application of antibiocs in our district. Methods Excretion specimens from raw surface of dia- betic - foot -infected patients was cultured to do susceptibility test by K- B or dilution method. Results Among the 95 exere- tion specimens from diabetic -foot -infected patients, 69(726%)were cultured out bacteria and disjuncted out 106 strains of pathogenic bacteria(PB), of which 51(481%)were gram-positive bacteria(GPB),50(472%)gram - negative bacteria (GNB),5(47%)eumycete; and of which 15 strains of extended spectrumβlactamases(ESBL) were found (341% of en- terobacteriaceae). Diabetic foot infection was mainly from coagulase negative staphylococcus(CN-S), staphylococcus aureus (SA), bacillus proteus(BP)and Escherichia coli(E coli); and fungous infection(FI) was also detected. According to susceptibility test,multi - cross drug resistance was found, GNB was sensitive to imipenem and antibiotic filled with plactamases inhibitor, and GPB to vancocin, amphemycin, an