【摘要】 目的 探讨糖尿病足溃疡(DFU)患者创面常见致病菌的分布特征及耐药性，为临床精准选用抗菌药物、优化感染控制策略提供实验室依据。方法 回顾性分析2020年7月1日～2025年6月30日本院收治的103例DFU患者的临床资料，采集创面分泌物进行细菌培养、分离鉴定及药敏试验，采用SPSS 26.0软件对数据进行统计学分析。结果 103例患者创面共检出致病菌132株，其中革兰阳性菌78株(59.09%),以金黄色葡萄球菌为主(35株，26.52%);革兰阴性菌50株(37.88%),以铜绿假单胞菌为主(15株，11.36%);真菌4株(3.03%)。单一菌株感染74例(71.84%),混合菌株感染29例(28.16%)。WagnerⅣ级溃疡患者革兰阴性菌检出率(56.67%)显著高于Ⅱ级(27.66%)和Ⅲ级(36.36%)(P<0.05)。耐药性分析显示，耐甲氧西林金黄色葡萄球菌(MRSA)检出率34.29%,对万古霉素、利奈唑胺均敏感；铜绿假单胞菌对亚胺培南、美罗培南耐药率均为13.33%;白色念珠菌对氟康唑、伊曲康唑、伏立康唑均敏感，光滑念珠菌对氟康唑耐药，对伊曲康唑、伏立康唑敏感。结论 DFU创面致病菌以革兰阳性菌为主，金黄色葡萄球菌和铜绿假单胞菌是主要致病菌，且存在不同程度耐药性；溃疡严重程度与致病菌分布相关，临床应根据药敏结果合理用药。更多还原

【Abstract】 Objective To explore the distribution characteristics and drug resistance of common pathogenic bacteria in the wounds of patients with diabetic foot ulcers(DFU),and to provide laboratory evidence for the clinical accurate selection of antibacterial drugs and optimization of infection control strategies. Methods A retrospective analysis was conducted on the clinical data of 103 DFU patients admitted to our hospital from July 1,2020 to June 30,2025. Wound secretions were collected for bacterial culture, isolation and identification, and drug sensitivity tests. SPSS 26.0 software was used for statistical analysis of the data. Results A total of 132 strains of pathogenic bacteria were detected from the wounds of 103 patients, including 78 strains of Gram-positive bacteria(59.09%),mainly Staphylococcus aureus(35 strains, 26.52%);50 strains of Gram-negative bacteria(37.88%),mainly Pseudomonas aeruginosa(15 strains, 11.36%);and 4 strains of fungi(3.03%). There were 74 cases of single-strain infection(71.84%) and 29 cases of mixed-strain infection(28.16%). The detection rate of Gram-negative bacteria in patients with Wagner grade Ⅳ ulcers(56.67%) was significantly higher than that in patients with grade Ⅱ(27.66%) and grade Ⅲ(36.36%)(P<0.05). Drug resistance analysis showed that the detection rate of methicillin-resistant S. aureus(MRSA) was 34.29%,and all MRSA strains were sensitive to vancomycin and linezolid; the drug resistance rates of P. aeruginosa to imipenem and meropenem were both 13.33%;Candida albicans was sensitive to fluconazole, itraconazole and voriconazole, while Candida glabrata was resistant to fluconazole but sensitive to itraconazole and voriconazole. Conclusion Gram-positive bacteria are the main pathogenic bacteria in DFU wounds, with S. aureus and P. aeruginosa being the primary ones, and different degrees of drug resistance exist. The severity of ulcers is associated with the distribution of pathogenic bacteria. Clinically, drugs should be used rationally based on the results of drug sensitivity tests.更多还原