摘要
目的探讨糖尿病足感染复发的病原菌种类、分布及影响其感染复发的因素。方法选取2013年10月至2015年1月本院收治的糖尿病足感染者共185例,收集其中复发感染的106例患者感染部位的标本进行常规细菌培养和药敏试验,并分析影响糖尿病足患者感染复发的相关因素。结果106例感染复发患者共培养出127株病原菌,其中革兰阳性菌(G+)占54.7%、革兰阴性菌(G-)占39.5%,其他病原菌占5.8%。其中革兰阳性菌对万古霉素产生耐药性的发生率较低;革兰阴性菌对帕尼培南产生耐药性的发生率较低。多因素Logistic回归分析结果显示,糖尿病足患者感染复发和细菌出现多重耐药性主要与近期应用抗菌药物、溃疡未愈合时间超过65 d以及周围血管病变有关(P=0.0268、0.0058和0.0045)。结论多种病原菌感染是导致糖尿病足患者感染复发的主要原因,且其对大多数的抗菌药物具有一定的耐药性,因此对抗菌药物的使用要严格控制;糖尿病足患者如果出现多重耐药病原菌、溃疡未愈合超过65 d或存在有周围血管病等情况时容易增加感染的复发几率,需对患者进行密切监护,及早进行临床干预,警惕复发的发生。
Objective To investigate the types, distribution and effect factors of pathogenic bacteria in patients with diabetic foot infection recurrence. Methods Total of 185 patients with diabetic foot in our hospital from October 2013 to January 2015 were collected. The routine bacterial culture and drug sensitive test of specimens of 106 patients with infection recurrence were detected, and the related factors of diabetic foot infection recurrence were analyzed. Results There were 127 pathogenic bacterias cultured, with 54.7% of Gram-positive bacteria, 39.5% of Gram-negative bacteria and 5.8% of others. The drug resistance rate of Gram-positive bacterium to vancomycin and Gram-negative bacteria to panipenem were both low. The results of multivariate Logistic regression analysis showed that diabetic foot infection recurrence and the multiple drug-resistant of bacterias were releated with antibiotics recently using, the healing time of ulcer longer than 65 days and peripheral vascular diseases（P = 0.0268, 0.0058 and 0.0045）. Conclusions A variety of pathogenic bacteria infection is the main reason which leads to diabetic foot infection recurrence, most of them have a certain drug resistance to the antimicrobial agents, therefore, the use of antibiotics should be controled strictly; multiple drug-resistant pathogens, the healing time of ulcer longer than 65 days and peripheral vascular disease could increase infection recurrence risk, which should be closely monitored and early clinical intervened.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2016年第2期244-247,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
关键词
糖尿病足
感染复发
病原菌
影响因素
Diabetic foot
Recurrence of infection
Pathogenic bacteria
Effect factors
