摘要
目的探讨深度不同的糖尿病足感染患者临床及实验室表现、病原菌种类及耐药率有无不同。方法收集我院350例2型糖尿病足感染患者资料,根据是否深及骨关节分为浅部感染组及深部感染组。收集基本资料、检查足溃疡感染情况,取足分泌物行细菌培养和药敏试验,比较两组临床及实验室数据、病原菌种类及耐药率的差异。结果深部感染组溃疡病程、发热、院前抗菌药物使用率、水肿、周围血管病变、超敏C反应蛋白、纤维蛋白原、血沉、白细胞数目、血小板数目、尿微量清蛋白、尿蛋白、对部分抗菌药物的耐药率、截肢率高于浅部感染组,清蛋白低于浅部感染组,差异有统计学意义(P<0.05)。浅部感染组以革兰阳性菌为主(56.3%,98/174),深部感染组以革兰阴性菌为主(57.1%,116/203),二者差异均有统计学意义(χ2值分别为72.414、100.266,P<0.01)。金黄色葡萄球菌对呋喃妥因,表皮葡萄球菌对左氧氟沙星、头孢呋辛的耐药率深部感染组均高于浅部感染组,差异有统计学意义(P<0.05)。结论深部感染病情更重,耐药率更高,易截肢。所有糖尿病足溃疡应早期多学科综合治疗,及时、定期行病原菌检测及药敏试验,调整抗菌药物,以提高创面愈合率。
Objective To explore the clinical and laboratory manifestations, pathogenic bacteria distribution, and antimicrobial resistance of superficial and deep foot infections in diabetic patients. Methods The data of 350 patients in our hospital with type 2 diabetes who had foot infection were collected. The cases were divided into a superficial infection group （166） and a deep infection group （184） , depending on whether the infection had reached the bone joint. Microbial culture and antimicrobial susceptibility testing were conducted on the infection secretion from the two groups. Results The course of infection was longer, ESR, incidence of fever, edema and peripheral arterial disease, rate of pre - hospital antibiotics use, resistance to certain antibiotics and amputation, amount of hs - CRP, fibrinogen, WBC, PLT, urinary microalbumin and urinary protein, were higher in the deep infection group than that of the superficial infection group. The amount of albumin in the secretion from the deep infection group was lower than that of the superficial infection group （ P 〈 0. 05 ） . The most common pathogens in the secretion from the superficial infection group were Gram -positive bacteria （56. 3% , 98/174）, while the most common pathogens in the secretion from the deep infection group were Gram - negative bacteria （57.1% , 116/203 ）. Resistance rates of Staphylococcus aureus to furadantin, Staphylococcus epidermidis to levofloxacin and cefuroxime were all higher in the deep infection group than the superficial infection group （ P 〈 0. 05 ） . Conclusion Deep foot infection in diabetic patients has severe medical conditions and high antimierobial resistance rate, and is liable to amputation. Regular microbial culture and antimicrobial susceptibility testing are necessary for choosing effective medication during treatment.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第34期4012-4015,共4页
Chinese General Practice
基金
天津市自然科学基金重点项目(10JCIDJC19800)
关键词
糖尿病足
感染
病原菌
耐药性
Diabetic foot
Infection
Pathogen
Resistance
