糖尿病足病与下肢血管病

　　【摘要】 目的 探讨糖尿病足溃疡(DFU)分泌物病原菌分布及药敏情况。 方法 回顾性分析2006至2010年我院内分泌科218例DFU患者分泌物病原菌分布及药敏情况。 结果 75例患者分泌物呈阳性，感染率为34.4%。DFU分泌物病原菌以革兰氏阳性菌为主(59株，61.46%);混合感染20例， Wagner3-5级患者的混合感染比例(40%)高于Wagner1-2级患者(15%)。革兰氏阳性球菌对万古霉素、阿米卡星、亚胺培南、美洛培南、利奈唑胺、头孢哌酮-舒巴坦敏感;未检出对亚胺培南、美洛培南耐药的革兰氏阴性杆菌;金黄色葡萄球菌和革兰氏阴性杆菌对头孢菌素耐药率较高。 结论 糖尿病足溃疡分泌物细菌以革兰氏阳性细菌为主，Wagner3-5级患者的混合细菌感染比例高于Wagner1-2级患者。细菌对头孢菌素的耐药情况严峻，对糖尿病足感染的病原菌及其药物敏感性进行检测，可为DFU感染治疗提供依据。

　　【关键词】 糖尿病足溃疡;病原菌;药敏分析

　　Distribution and drug sensitivity of pathogens in diabetic foot ulcer secretions LI Hui-qin, SU Xiao-fei, XIE Xiao-jing, et al. Department of Endocrinology, Nanjing Hospital, Nanjing Medical University, Nanjing 210029, China

　　Corresponding author: MA Jian-hua , Email: majianhua@china.com.

　　【Abstract】 Objective To investigate the distribution and drug sensitivity of pathogens isolated from diabetic foot ulcer (DFU) secretions. Methods A retrospective study was carried out on the distribution and drug sensitivity of pathogens isolated from the secretions of 218 DFU patients treated in the Department of Endocrinology of our hospital from 2006 to 2010. Results The pathogens of secretions in 75 patients were positive, and the infection rate was 34.4%. Gram-positive bacteria (59 strains, 61.46%) were the main pathogens of DFU. Twenty patients were with composite infections, and incidence of Wagner’s grade 3～5 (40%) was higher than Wagner’s grade 1～2 (15%). Gram-positive cocci were sensitive to vancomycin, amikacin, imipenem, meropenem, linezolid, and cefoperazone sulbactam; no Gram-negative bacteria was detected to be resistant to imipenem or meropenem. S.aureus and Gram-negative bacteria had high drug resistance rate to cephalosporin. Conclusions The pathogens isolated from DFU secretions were mainly of Gram-positive bacteria and the incidence of composite infections of Wagner’s grade 3～5 was higher than Wagner’s grade 1～2. The drug resistance of the bacteria to cephalosporin was severe. Monitoring the pathogens of the DFU patients and their drug sensitivity can provide evidences for the treatment of DFU infection.

　　【Key words】 Diabetic foot ulcer; Pathogen; Analysis on drug sensitivity