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PDF(1168 KB)
糖尿病足溃疡创面特点及主要细菌分布的研究
Study on diabetic foot ulcer characteristics and main bacterial distribution
本文旨在探讨糖尿病足(DF)溃疡创面的临床特点及细菌谱的分布特点。采用SPSS17.0统计软件回顾性分析2012~2014年青岛市城阳人民医院内分泌科210例住院DF患者的溃疡创面临床特征、临床转归及主要病原菌分布情况,以及时了解DF患病情况和细菌分布及药敏情况,及时调整抗生素应用。结果显示,DF的诊治率逐年上升,溃疡创面显示以肌腱坏死、浅表溃疡及干湿性混合创面为主,浅表溃疡好转率最高。革兰阳性球菌感染率为56.3%,以金黄色葡萄球菌最常见,占25.2%,检出的金黄色葡萄球菌对万古霉素、利奈唑胺及莫西沙星敏感度较高(分别为100%、99%和98%)。革兰阴性杆菌感染率为39.8%,检出的大肠埃希菌及奇异变形杆菌对亚胺培南、头孢哌酮钠及哌拉西林敏感度较高(分别为99%、98%和95%)。本研究证实,DF患者溃疡创面和细菌分布复杂、多样,耐药菌感染的危险因素为血糖、病程及创面复杂性,有利于指导临床上更加合理选用抗生素。
To investigate the clinical characteristics of diabetic foot (DF) and the distribution of bacteria. The clinical characteristics, clinical outcomes and distribution of main pathogenic bacteria of 210 DF cases in Chengyang People’s Hospital of Qingdao were analyzed by SPSS17.0 software. The results showed that DF morbidity was rising. Tendon necrosis, superficial ulcer and dry and wet mixed wound were tha main manifestations. The superficial ulcer had the highest improvement rate. The infection rate of Gram positive cocci was 56.3%. Staphylococcus aureus was the most common pathogen, accounting for 25.2%. The resistance rates of Staphylococcus aureus to vancomycin, linezolid and moxifloxacin were 100%, 99% and 98%, respectively. The infection rate of Gram negative bacillus was 39.8%. The resistance rates of Escherichia coli and Proteus mirabilis to imipenem, cefoperazone sodium and piperacillin were 99%, 98% and 95%, respectively. The results suggest that the distribution of bacteria in DF ulcers is complex. The risk factors of drug resistance include blood glucose, duration and complexity of wound. This study is helpful to guide rational selection of antibiotics in clinic.
Diabetic foot / Ulcer wound / Clinical outcome / Bacterial spectrum
青岛市优秀医学人才计划项目(2015040)
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