青岛地区糖尿病足感染患者病原学特点及耐药性
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赵自云

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R587.1

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Characteristics and antimicrobial resistance of pathogens causing diabetic foot infection in patients in Qingdao
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    摘要:

    目的了解糖尿病足溃疡部位感染的病原菌分布及其耐药性。方法2012年6月—2013年6月,使用无菌拭子采集青岛市中心医疗集团所属各医院以及周边社区医院内分泌科、烧伤整形科等科室就诊糖尿病足患者溃疡部位分泌物,浸于无菌肉汤中送检,做细菌培养和药敏试验。 结果共采集137例患者的标本,培养分离到病原菌216株,其中革兰阴性杆菌127株(58.80%),革兰阳性球菌86株(39.81%),真菌3株(1.39%);其中单一病原菌感染76例(55.47%),混合病原菌感染61例(44.53%);检出数量前5位分别为铜绿假单胞菌(37株)、金黄色葡萄球菌(35株)、大肠埃希菌(26株)、表皮葡萄球菌(24株)和鲍曼不动杆菌(22株)。肠杆菌科细菌对阿米卡星、阿莫西林/克拉维酸、头孢西丁、亚胺培南、哌拉西林/他唑巴坦、替卡西林/克拉维酸的耐药率(0~16.67%)较低;铜绿假单胞菌对亚胺培南、妥布霉素、阿米卡星、头孢吡肟、庆大霉素、喹诺酮类药物耐药率(2.70%~18.92%)较低;鲍曼不动杆菌耐药情况最为严重,除亚胺培南和左氧氟沙星外,耐药率均在30%以上。 结论该地区糖尿病足溃疡部位病原菌感染以革兰阴性杆菌为主,其次为革兰阳性球菌,各菌属的耐药性有较大差异,临床医生应根据药敏结果合理选择抗菌药物。

    Abstract:

    ObjectiveTo investigate the distribution and antimicrobial resistance of pathogens causing diabetic foot ulcer(DFU).  MethodsSecretion specimens of DFU in patients at several hospitals in Qingdao were collected and performed bacterial culture and antimicrobial susceptibility testing.  ResultsA total of 216 pathogens were obtained from 137 patients with DFU. Isolation rate of gramnegative bacilli, grampositive cocci and fungi was 58.80% (n=127), 39.81% (n=86) and 1.39%(n=3) respectively. 76 (55.47%)patients were infected with single pathogen, 61 (44.53%)were infected with mixed pathogens;the top five detected pathogens were Pseudomonas aeruginosa(n=37), Staphylococcus aureus (n=35), Escherichia coli (n=26), Staphylococcus epidermidis(n=24), and Acinetobacter baumannii(n=22). The resistance of Enterobacteriaceae to amikacin, amoxicillin / clavulanic acid, cefoxitin, imipenem, piperacillin / tazobactam, ticarcillin / clavulanic acid were 0-16.67%;the resistance of Pseudomonas aeruginosa to  imipenem, tobramycin, amikacin, cefepime, gentamicin, and quinolones were 2.70%-18.92%;the resistance of Acinetobacter baumannii to imipenem and levofloxacin were low,but to the other antimicrobial agents were all above 30%. ConclusionThe major pathogens from DFU were gramnegative bacilli, the next were grampositive cocci, antimicrobial resistance patterns of each species are quite different, clinicians should choose antimicrobial agents according to antimicrobial susceptibility testing results.

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引用本文

李莉, 赵自云.青岛地区糖尿病足感染患者病原学特点及耐药性[J]. 中国感染控制杂志,2014,13(11):669-673. DOI:10.3969/j. issn.1671-9638.2014.11.008.
LI Li.,ZHAO Ziyun. Characteristics and antimicrobial resistance of pathogens causing diabetic foot infection in patients in Qingdao[J]. Chin J Infect Control, 2014,13(11):669-673. DOI:10.3969/j. issn.1671-9638.2014.11.008.

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  • 收稿日期:2014-02-02
  • 最后修改日期:2014-04-22
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  • 在线发布日期: 2014-11-30
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