糖尿病足发生多重耐药菌感染的危险因素分析.docVIP

·1689 · · 论 著 · 糖尿病足发生多重耐药菌感染的危险因素分析 黄德斌，李晓行，邵芬，林丽萍，章臻翊 【摘要】 目的 探讨糖尿病足感染多重耐药菌 (MDRMs) 的分布特点、耐药情况及糖尿病足感染 MDRMs 的危 险因素。方法 对本院内分泌代谢病科及骨科2006年9月—2011年3月收治的所有糖尿病足感染患者的病原菌培养及 药敏结果进行回顾性分析。以发生MDRMs 感染的糖尿病足患者34例为病例组，其余73例为对照组，分析MDRMs 感 染的危险因素。结果 病例组共分离出51株MDRMs, 居前三位的MDRMs 分别是金黄色葡萄球菌(41.2%)、铜绿假 单孢菌(23.5%)和肠杆菌(21.6%)。多因素Logistics 回归分析显示，既往抗菌药物暴露史、暴露时间、因同一感 染伤口住院次数2次/年、神经缺血性伤口及合并骨髓炎与糖尿病足感染 MDRMs 有关 (P0.05)。 结论 既往抗菌 药物暴露史、暴露时间、因同一感染伤口住院次数2次/年、神经缺血性伤口及骨髓炎与糖尿病足患者发生MDRMs 感染密切相关。 【关键词】 糖尿病足；感染；多重耐药菌；危险因素 【中图分类号】 R587.1 【文献标识码】 A 【文章编号】1007-9572(2012)05-1689-04 Risk Factors for Infections of the Diabetic Foot with Multidrug Resistant Microorganisms HUANG De -bin,LI Xiao - xing, SHAO Fen, et al. Department of Endocrinology and Metabolism, the Third Hospital of Changsha, Changsha 410015, China 【Abstract] Objective To determine the distribution features and the present condition of drug resistance as well as the related risk factors for diabetic foot infection with multi - drug resistant microorganisms(MDRMs). Methods We analyzed ret- rospectively all patients with diabetic foot infections admitted to the departments of Endocrinology and Metabolism and Orthopedics in the third hospital of Changsha between September 2006 and March 2011 about the pathogenic bacteria culture and drug sensitiv- ity results,from which we chose 34 patients with infection of MDRMs as the case group and 73 without MDRMs as the control group for risk factors analysis of MDRMs infections. Results 51 MDRMs strains were isolated from 34 patients in the case group, among which the top three were Staphylococcus aureus(41.2%),Pseudononas aeruginosa(23.5%),Enterobacter spp(21.6%). Multi-factor logistic analysis revealed that previous antibiotics explosure histories and its duration, frequency of hospitalization for the same wound which was above 2 times a year, the presence of neuroischemic wounds and osteomyelitis were significant risk factors for infections with multidrug