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目的研究糖尿病足溃疡感染病原菌分布,并对其临床耐药性进行相关分析,为临床预防治疗提供参考依据。方法对2011年5月-2013年5月在医院就诊的178例糖尿病足溃疡感染患者的溃疡物或脓性分泌物,进行病原菌培养及药敏分析,病原菌培养严格按照临床操作流程逐步进行,药敏试验采用纸片扩散法进行,采用SPSS 13.0统计软件对数据进行处理。结果 178例患者共分离出病原菌214株,其中革兰阴性菌124株占57.9%,革兰阳性菌65株占30.4%,真菌25株占11.7%;病原菌排名前5位的分别为大肠埃希菌、普通变形菌、金黄色葡萄球菌、类肠球菌、肺炎克雷伯菌,分别占15.4%、9.8%、8.9%、8.4%、6.1%;革兰阴性菌对哌拉西林、阿米卡星以及头孢拉定较为敏感,敏感率>75.0%;革兰阳性菌对万古霉素以及庆大霉素较为敏感,敏感率>85.0%;真菌对氟康唑以及伏立康唑较为敏感,敏感率>81.5%。结论在临床治疗过程中,可以根据药敏试验结果及时调整抗菌药物,以促进溃疡早期愈合。
Objective To study the distribution of pathogenic bacteria in diabetic foot ulcer and to analyze its clinical drug resistance and provide a reference for clinical prevention and treatment. Methods From May 2011 to May 2013, 178 cases of diabetic foot ulcer infection in patients with ulcer or purulent secretions, pathogen culture and drug susceptibility analysis, pathogen culture in strict accordance with the progress of clinical procedures, medicine Sensitivity test using disk diffusion method, using SPSS 13.0 statistical software for data processing. Results A total of 214 pathogenic bacteria were isolated from 178 patients, of which 124 were Gram-negative bacteria, 57.9% were Gram-negative bacteria, 65 strains were Gram-positive bacteria, 30.4% were Gram-positive bacteria and 25 strains were 11.7%. The top five pathogens were Escherichia coli Staphylococcus aureus, Enterococcus and Klebsiella pneumoniae accounted for 15.4%, 9.8%, 8.9%, 8.4% and 6.1% respectively. Gram-negative bacteria were resistant to piperacillin and amikacin Star and cefradine were more sensitive, with a sensitivity of> 75.0%. Gram-positive bacteria were more sensitive to vancomycin and gentamicin, with a sensitivity of> 85.0%. Fungi were more sensitive to fluconazole and voriconazole with a sensitivity of> 81.5%. Conclusion In the course of clinical treatment, antimicrobial agents can be adjusted in time according to the results of drug susceptibility test to promote the early healing of ulcer.