老年糖尿病足患者病原菌分布及耐药性分析

目的 分析老年糖尿病足患者感染常见病原菌及耐药情况,探讨防治对策.方法 采用回顾性调查方法,调查并分析我院收治的68例老年糖尿病足感染患者分泌物中所分离的136株病原菌及其耐药状况.结果 老年糖尿病足患者感染病原体中,细菌性占92.6％,真菌性占7.4％.在细菌性病原体中,革兰阳性菌感染占58.7％,其中葡萄球菌属最为多见,且耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)发生率呈逐年上升趋势,未见对万古霉素耐药的革兰阳性球菌；革兰阴性杆菌感染占41.3％,其中以肠杆菌科细菌最为多见；混合感染病例占61.8％,真菌感染均以混合感染形式出现,呈逐年上升趋势.结论 及时对糖尿病足感染的病原菌及其耐药性进行监测,有利于老年人糖尿病足感染的防治.

Distribution and drug resistance pathogens isolated from the elderly patients with diabetic foot

Objective To approach the strategies of prevention and treatment of elderly patients with diabetic foot by analyzing the common pathogens and their drug- resistance.Methods 136 isolated strains of drug resistance pathogens from 68 elderly patients with infected diabetic foot were retrospectively studied in our hospital from January 2008 to June 2010.Results Bacterial pathogens and fungal pathogens accounted for 92.6％ and 7.4 ％,respectively.The bacterial pathogens included gram-positive bacteria (58.7％) and gram-negative bacilli (41.3％).Among the gram-positive bacteria,staph were most common.Furthermore,the incidence of methicillin resistant staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococcus (MRCNS) increased year by year.Vancomycin-resistant gram-positive bacteria did not appear.Among the gram-negative bacilli,enterobacteriaceae were the most common pathogens.Patients with mixed infections accounted for 61.8％.Fungous infections were all in the form of mixed infection,increasing with years.Conclusions Pathogenic bacteria and its drug resistance should be timely monitored to control and prevent the diabetic foot in the elderly patients.