摘要
目的了解近年来我院住院的糖尿病足患者伤口感染标本病原菌变迁及病原菌与患者踝肱指数(ankle brachial index,ABI)的关系。方法回顾性分析我院2017年1月—2021年1月住院的168例糖尿病足患者的伤口分泌物病原菌培养及药敏实验,2017年1月—2019年1月称前2年组共76例,2019年2月—2021年1月称近2年组共92例。按照ABI水平分为非动脉硬化组(非PAD组,0.9≤ABI≤1.30)94例及动脉硬化组(PAD组,ABI>1.30或ABI<0.9)74例。并收集比较其临床资料。结果168例糖尿病足患者的分泌物培养中,共培养菌株116株,近2年组单纯革兰阴性感染比例明显增多(P=0.027)。多重耐药菌感染率从前2年组的17.10%升高到近2年组的31.52%(P=0.032)。近2年组革兰阴性菌对克林霉素的耐药率较前2年组耐药率增加(P<0.05),PAD组混合感染及单纯革兰阴性的发生率及多重耐药菌感染发生率高于非PAD组。PAD组糖尿病足的Wagner分级明显高于非PAD组。结论近2年糖尿病足患者病原菌分布及耐药情况有所变化,糖尿病周围血管病变影响糖尿病足细菌感染的类型且与糖尿病足的Wagner分级相关。
Objective To analyze distribution characteristics of pathogenic bacteria and the relationship with ankle brachial index(ABI)in diabetic foot patients.Methods A total of 168 diabetic foot patients who were admitted to The Second Affiliated Hospital of Xiamen Medical College from January 2017 to January 2021 were included in this study to analyze the pathogens and antimicrobial susceptibility testing result.There were 76 cases in the previous 2 years(from January 2017 to January 2019),and 92 cases in the past 2 years(from February 2019 to January 2021).According to the level of ABI,94 patients were divided into non-peripheral artery disease group(non-PAD group,0.9≤ABI≤1.30)and 74 patients were divided into peripheral artery disease group(PAD group,ABI>1.30 or ABI<0.9).Results There were totally 116 strains of pathogenic bacteria in 168 patients.The proportion of simple Gram-negative infection has increased significantly in the past 2 years(P=0.027).Rate of multiple drug-resistant bacteria infection increased from 17.10%in the previous 2 years to 31.52%in the past 2 years(P=0.032).The resistance rate of Gram-negative bacteria to clindamycin in the past 2 years increased compared with the previous 2 years(P<0.05).The incidence of mixed infection,simple Gram-negative infection and multi-resistant infections in PAD group were higher than those in non-PAD group.Wagner classification of diabetic foot in PAD group was significantly higher than that in non-PAD group.Conclusion The distribution and resistance of pathogens in diabetic foot patients have changed in the past 2 years.Diabetic peripheral artery disease affect the type of diabetic foot bacterial infection and are associated with the Wagner classification of the diabetic foot.
作者
沈小燕
柯文志
林鹭平
罗芳涛
陈美贞
宋渊浩
林志华
SHEN Xiaoyan;KE Wenzhi;LIN Luping;LUO Fangtao;CHEN Meizhen;SONG Yuanhao;LIN Zhihua(Department of Endocrinology,The Second Affiliated Hospital of Xiamen Medical College,Xiamen Fujian 361021,China;Department of Intensive Care Unit,Xiamen No.3 Hospital,Xiamen Fujian 361100,China)
出处
《中国卫生标准管理》
2022年第10期95-98,共4页
China Health Standard Management
基金
福建省厦门科技计划项目(3502Z20194062)。
关键词
糖尿病足
病原学特点
踝肱指数
耐药率
Wagner分级
糖尿病周围血管病变
diabetic foot
pathogen characteristics
ankle brachial index
resistance rate
Wagner rating
diabetic peripheral artery disease
