摘要
目的探讨糖尿病周围神经病变合并足坏疽感染病原菌分布特点及耐药情况。方法回顾性分析2012年3月-2018年3月在丽水市中医院就诊的113例糖尿病合并足坏疽感染患者的临床资料,对患者血培养后的血液标本所分离出的病原菌及其耐药性进行分析。结果糖尿病周围神经病变合并足坏疽感染的病原菌主要为革兰阴性菌60株占49.59%,其中肺炎克雷伯菌、铜绿假单胞菌及大肠埃希菌为主,分别为12.40%、11.57%和9.92%,革兰阳性菌59株占48.76%,主要以金黄色葡萄球菌、表皮葡萄球菌及粪肠球菌为主,分别为11.57%、11.57%和10.74%,真菌2株占1.65%。肺炎克雷伯菌耐氨苄西林15株、红霉素12株及左氧氟沙星10株,耐美罗培南0株,亚胺培南1株。葡萄球菌耐青霉素2株、氨苄西林11株,耐替考拉宁1株、多西环素1株、万古霉素0株。结论糖尿病周围神经病变合并足坏疽感染患者病原菌主要是以革兰阴性菌为主,在治疗感染时,根据患者病原学检查与药敏试验结果选用抗菌类药物,防止抗菌类药物的滥用,减少细菌耐药情况的发生。
OBJECTIVE To investigate the distribution characteristics and drug resistance of pathogenic bacteria in diabetic peripheral neuropathy with foot gangrene infection. METHODS Retrospective analysis of 113 patients with diabetes mellitus complicated with foot gangrene infection in Lishui Hospital of Traditional Chinese Medicine from March 2012 to March 2018 were recruited. The pathogens were isolated from blood samples after blood culture, and the drug resistance were analyzed. RESULTS Sixty Gram-negative bacteria strains were isolated, accounted for 49.59% of the pathogens associated with gangrene infection in diabetic peripheral lesions, in which, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli accounted for 12.40%, 11.57% and 9.92%, respectively. Gram-positive bacteria accounted for 48.76%, mainly including Staphylococcus aureus(11.57%), Staphylococcus epidermidis(11.57%) and Enterococcus faecalis(10.74%), two strains of fungi(1.65%) and et.al. Fifteen strains of Klebsiella pneumoniae were resistant to ampicillin, 12 strains were resistant to erythromycin, 10 strains were resistant to levofloxacin strains, 1 strain was resistant to imipenem, and no strain was resistant to meropenem. Two strains of Staphylococcus were resistant to penicillin;11 strains were resistant to ampicillin;1 strain was resistant to teicoplanin;1 strain was resistant to doxycycline;no strain was resistant to vancomycin. CONCLUSION Gram-negative bacteria are the main pathogens in diabetic peripheral neuropathy patients with foot gangrene infection. In the treatment of infection, the most suitable antibiotics should be selected according to the results of etiological examination and drug sensitivity test, so as to prevent the abuse of antibiotics and reduce the occurrence of bacterial resistance.
作者
杨群菲
张征宇
徐丽霞
高芸
孙亮
YANG Qun-fei;ZHANG Zheng-yu;XU Li-xia;GAO Yun;SUN Liang(Lishui Traditional Chinese Medicine Hospitals Lishui,Zhejiang 323000»China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第24期3786-3789,共4页
Chinese Journal of Nosocomiology
基金
浙江省中医药科技基金资助项目(2017ZA145)
关键词
糖尿病
坏疽
病原菌
药敏
周围神经病变
Urinary disease
Gangrene
Pathogenic bacteria
Drug sensitivity
Peripheral neuropathy
