【摘要】 目的分析糖尿病足(DF)合并感染的病原菌分布特点及药敏变迁,指导临床用药。方法回顾性分析2006～2017年于吉林大学第一医院内分泌科和手足外科住院治疗的DF患者330例,按照入院日期分为2006～2011年组及2012～2017年组,比较两组间病原菌分布特点及药敏变迁。结果 330例患者中,溃疡面拭子标本共培养细菌菌株362株,革兰阳性菌(G+)比例较高(59. 7%),以葡萄球菌属为主;革兰阴性菌(G-)中以条件致病菌为主。随着Wagner级别增加,G-比例升高。与2006～2011年组比较,2012～2017年组菌株种类增多,但整体菌株构成比未见明显改变,而G+中葡萄球菌属对头孢西丁的耐药率由64. 7%升至100%,G-对头孢呋辛的耐药率由57. 1%升至78. 7%,且新发现少数亚胺培南耐药菌。结论 DF感染以葡萄球菌属比例最高。随着Wagner级别增加,G-比例升高。与2006～2011年组比较,细菌对青霉素、红霉素、阿奇霉素、克林霉素保持较高的耐药率,尤其对头孢西丁、头孢呋辛的耐药率升高明显。更多还原

【Abstract】 Objective To investigate the pathogens distribution and the antibiotic susceptibilities in diabetic foot infection,and to provide guidance for reasonable antibiotics therapy in clinic.Methods A retrospective study was carried out in 330 patients with diabetic foot in three Grade-A Tertiary Hospital including The First Hospital of Jilin University from 2006 to 2017. All the patients were divided into two groups by date of admission:2006 to 2011 group and 2012 to 2017 group. The changes of pathogen and drug susceptibility were compared between the two groups.Results A total of 362 strains of pathogens were isolated in 330 patients and the gram-positive bacteria were the main isolated bacteria(59. 7%). Grampositive bacteria were mainly staphylococcus,and the main pathogens of gram-negative bacteria were conditional pathogenic bacteria. With rising Wagner grade,bacterial floras transformed from gram-positive bacteria to gram-negative bacteria. There were more kinds of strains in 2012 to 2017 group than in 2006 to2011 group,while the distribution of the strains was similar. In gram-positive bacteria,the resistance rate of staphylococcus to ceficidin was increased(from 64. 7% to 100%). In Gram-positive bacteria,the resistance rate of cefoperazone increased from 57. 1% to 78. 7%,and a few imipenem resistant bacteria were found compared with 2006 to 2011 group.Conclusion Staphylococcus was the most common group of diabetic foot infections. With rising Wagner grade,bacterial floras transformed from gram-positive bacteria to gramnegative bacteria. Bacteria maintained high resistance to penicillin,erythromycin,azithromycin and clindamycin,and increased their resistance to cefoxitin.更多还原