糖尿病足溃疡面细菌培养及药敏特点分析

目的 探讨我院住院糖尿病足患者溃疡面病原菌种类及抗菌药物敏感变化情况.方法 对2003年至2010年我院收治的69例糖尿病足合并溃疡患者创面分泌物进行细菌培养和药敏特点分析.结果 ①2003～2010年糖尿病足感染呈逐年上升趋势；共分离出病原菌87株,其中革兰氏阳性球菌55株、革兰氏阴性杆菌27株、真菌5株.②糖尿病足溃疡感染病原菌以金黄色葡萄球菌、粪肠球菌、变形杆菌、链球菌属为主.药敏试验显示革兰氏阳性菌未对万古霉素耐药;阿米卡星对革兰氏阴性菌抗菌活性最高；耐甲氧西林金黄色葡萄球菌( MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRC NS)、耐甲氧西林葡萄球菌(MRS)、凝固酶阴性葡萄球菌(CNS)均未对万古霉素耐药.结论 糖尿病足溃疡感染病原菌以革兰氏阳性菌为主,细菌对药物耐药率较高,应及早进行病原菌培养及药敏试验,为糖尿病足溃疡感染合理选择抗菌素提供依据.

Analysis on Germiculture and Characteristics of Drug Susceptibility of the Patients with Diabetic Foot Ulcer Surface

Objective To explore the pathogenic bacteria species of inpatients with diabetic foot ulcer surface and their sensitivities to antibiotics. Methods A retrospective study was carried out on the 87 strains of pathogens isolated from the wound surface secretion of 69 inpatients with diabetic foot ulcer and the changing trend of drug sensitive from 2003 to 2010. Results ①The infections in diabetic foot were increasing from 2003 to 2010. In 87 strains, 63.2% were Gram positive （G＋） bacteria, 31.1% were Gram negative（G） bacteria, and 5.7% were fungi. ②Staphylococcus aureus, enterococcus faecalis, proteus and streptococcus were main pathogenic bacteria in diabetic foot ulcer infections. The G＋ bacteria were all sensitive to vancomycin. The sensitivity of G bacteria to amikacin was the highest. MRSA, MRCNS, MRS and CNS were all sensitive to vancomycin. Conclusion The G＋ bacteria are predominant in diabetic foot ulcer infections. The drug resistance rates of bacteria are very high. We should pay attention to germiculture of diabetic foot ulcer and drug sensitive test as soon as possible to provide a guideline in choosing antibiotics reasonably for diabetic foot infections.