不同深度糖尿病足感染患者的临床表现、病原菌特点及耐药性研究.docVIP

·4012 · · 用 药 指 导 · 不同深度糖尿病足感染患者的临床表现、病原菌特点 及耐药性研究 郭婕，王鹏华，褚月颉，徐俊，丁敏，冯书红，孙好杰，郑丛丛 【摘要】 目的 探讨深度不同的糖尿病足感染患者临床及实验室表现、病原菌种类及耐药率有无不同。方法 收集我院350例2型糖尿病足感染患者资料，根据是否深及骨关节分为浅部感染组及深部感染组。收集基本资料、检 查足溃疡感染情况，取足分泌物行细菌培养和药敏试验，比较两组临床及实验室数据、病原菌种类及耐药率的差异。 结果 深部感染组溃疡病程、发热、院前抗菌药物使用率、水肿、周围血管病变、超敏 C 反应蛋白、纤维蛋白原、血 沉、白细胞数目、血小板数目、尿微量清蛋白、尿蛋白、对部分抗菌药物的耐药率、截肢率高于浅部感染组，清蛋白 低于浅部感染组，差异有统计学意义 (P0.05)。 浅部感染组以革兰阳性菌为主(56.3%,98/174),深部感染组以 革兰阴性菌为主(57.1%,116/203),二者差异均有统计学意义 (x2 值分别为72.414、100.266,P0.01)。 金黄色 葡萄球菌对呋喃妥因，表皮葡萄球菌对左氧氟沙星、头孢呋辛的耐药率深部感染组均高于浅部感染组，差异有统计学 意义 (P0.05)。 结论 深部感染病情更重，耐药率更高，易截肢。所有糖尿病足溃疡应早期多学科综合治疗，及 时、定期行病原菌检测及药敏试验，调整抗菌药物，以提高创面愈合率。 【关键词】 糖尿病足；感染；病原菌；耐药性 【中图分类号】 R681.533 【文献标识码】 A 【文章编号】1007-9572(2012)12-4012-04 Clinical Manifestations,Pathogenic Bacteria Distribution and Antimicrobial Resistance of Superficial and Deep Foot In- fections in Diabetic Patients GUO Jie, WANG Peng-hua, CHU Yue-jie,et al. Department of Diabetic Foot,Key Laborato- ry of Hormones and Development (Ministry of Health),Metabolic Diseases Hospital of Tianjin Medical University, Tianjin 300070,China 【Abstract】 Objective To explore the clinical and laboratory manifestations, pathogenic bacteria distribution, and an- timicrobial resistance of superficial and deep foot infections in diabetic patients. Methods The data of 350 patients in our hospital with type 2 diabetes who had foot infection were collected. The cases were divided into a superficial infection group(166)and a deep infection group(184),depending on whether the infection had reached the bone joint. Microbial culture and antimicrobial susceptibility testing were conducted on the infection secretion from the two groups. Results The course of infection was longer, ESR, incidence of fever,edema and peripheral arterial disease,rate of pre-hospital antibiotics use, resistance to certain anti- biotics and amputation, amount of hs-CRP, fibrinogen,WBC, PLT,urinary microalbumin and urinary protein, were higher in the deep infection group than that