摘要
目的分析2型糖尿病足患者Wagner1不同分级的病原菌分布情况以及药敏结果。方法回顾性分析的516例2型糖尿病足患者均在2024年1月至2024年10月期间收集,根据感染程度分为三组,轻度组(Wagner1级-2级,n=71),中度组(Wagner3级,n=52),重度组(Wagner4级-5级,n=45),采集所有患者病损边缘深部组织进行病原菌鉴定,并针对重点病原菌进行药敏试验。结果516例2型糖尿病足患者,经检测感染的有168例,占32.56%,其中革兰阴性菌78例,占46.43%,革兰阳性菌85例,占50.59%,真菌5例,占2.98%。重度组WBC、CRP以及下肢动脉病变的狭窄程度率>50%、极重度感觉异常率高于轻度组、中度组(P<0.05),ABI低于轻度组、中度组。而在比较不同感染程度患者病原菌分布情况时,轻度组以革兰阳性菌中金黄色葡萄球菌最为常见,所占比为15.48%;中度组、重度组以革兰阴性菌中大肠埃希菌最为常见,均占7.14%。从不同感染程度患者病原菌分布的关联关系看,“革兰阳性菌-链球菌”实例数为19,支持度11.310%;“革兰阴性菌-肺炎克雷伯菌”规则实例数26,支持度15.476%,“革兰阴性菌-大肠埃希菌”规则里,实例数30,支持度17.857%。药敏结果显示,轻度组患者金黄色葡萄球菌对利奈唑胺、万古霉素有较高的敏感性,中度组、重度组患者大肠埃希菌对亚胺培南、阿米卡星有较高的敏感性。结论不同感染程度2型糖尿病足患者病原菌分布不同,轻度感染以金黄色葡萄球菌为主,中度、重度感染以大肠埃希菌为主,需根据主要致病菌经验性选择相应抗生素,以提高治疗效果。
Objective To analyze the distribution of pathogens in different grades of Wagner 1 in patients with type 2 diabetes foot and the results of drug sensitivity.M ethods Retrospective analysis of 516 cases of type 2 diabetes foot patients were collected from January 2024 to October 2024.They were divided into three groups according to the degree of infection,mild group(Wagner 1-2,n=71),Moderate group(Wagner grade 3,n=52),Severe group(Wagner grades 4-5,n=45),Collect all patients'lesion edge deep tissues for pathogen identification,and conduct drug sensitivity tests on key pathogens.Results Among 516 cases of type 2 diabetes foot patients,168 cases(32.56%)were detected to be infected,including 78 cases(46.43%)of Gram negative bacteria,85 cases(50.59%)of Gram positive bacteria,and 5 cases(2.98%)of fungi.The stenosis degree rate ofWBC,CRP,and lower limb arterial disease in the severe group was greater than 50%,and the rate of extremely severe sensory abnormalities was higher than that in the mild and moderate groups(P<0.05).The ABI was lower than that in the mild and moderate groups.When comparing the distribution of pathogens in patients with different levels of infection,Sta ph ylococcus aureus,a Gram positive bacterium,was the most common in the mild group,accounting for 15.48%;In the moderate and severe groups,Escherichia coli was the most common Gram negative bacteria,accounting for 7.14%.From the correlation between the distribution of pathogens in patients with different levels of infection,the number of instances of"gram-positive bacteria Streptococcus"is 19,with a support rate of 11.310%;The number of instances in the"Gram negative bacteria Klebsiella pneumoniae"rule is 26,with a support rate of 15.476%.In the"Gram negative bacteria E.coli"rule,the number of instances is 30,with a support rate of 17.857%.The drug sensitivity results showed that S.aureus in the mild group had a higher sensitivity to linezolid and vancomycin,while E.coli in the moderate and severe groups had a higher sensitivity to imipenem and amikacin.Conclusion The distribution of pathogenic bacteria in patients with type 2 diabetes foot varies according to the degree of infection.S.aureus is the main cause of mild infection,and E.coli is the main cause of moderate and severe infection.It is necessary to select appropriate antibiotics according to the experience of the main pathogenic bacteria to improve the treatment effect.
作者
郭天缘
陈楠
GUO Tianyuan;CHEN Nan(Endocrinology Department of Tangshan Workers'Hospital,Tangshan,Hebei 063000,China)
出处
《中国病原生物学杂志》
北大核心
2026年第1期94-98,共5页
Journal of Pathogen Biology
关键词
2型糖尿病足
感染
病原菌
特征
耐药性
Type 2 diabetic foot
infection
pathogen
characteristics
drug resistance
