2016—2017年天津市宝坻区人民医院糖尿病足患者病原菌分布及药敏性分析

目的 探讨2016年1月—2017年12月天津市宝坻区人民医院糖尿病足患者感染病原菌的分布和耐药性情况，为临床合理用药提供依据。方法 选取天津市宝坻区人民医院2016—2017年糖尿病足患者139例，对其感染病原菌的分布及药敏结果进行回顾性分析。结果 共分离出病原菌145株，其中革兰阳性菌59株，构成比为40.69%，主要为金黄色葡萄球菌、表皮葡萄球菌；革兰阴性菌86株，构成比为59.31%，主要为大肠埃希菌、阴沟肠杆菌、奇异变形杆菌和肺炎克雷伯菌。革兰阳性菌对万古霉素、利奈唑胺、替加环素、莫西沙星、利福平、左氧氟沙星等较为敏感，革兰阴性菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星等较为敏感。结论 对于糖尿病足患者，特别是Wagner分级较高患者应及时开展溃疡分泌物的病原学检查与药敏试验，为临床合理使用抗菌药物提供依据。

Analysis on distribution and drug resistance of pathogens of patients with diabetic foot infections in Tianjin Baodi People's Hospital from 2016 to 2017

Objective To investigate the distribution and drug resistance of pathogenic bacteria of patients with diabetic foot infections in Tianjin Baodi People''s Hospital from 2016 to 2017, and to provide reference for clinical rational drug use.Methods Patients (139 cases) with diabetic foot infections were selected from Tianjin Baodi People''s Hospital, and the distribution and drug resistance of pathogenic bacteria were analyzed retrospectively. Results Totally 145 strains of pathogens were isolated, in which Gram-positive bacteria (59 strains) accounted for 40.69%, and main of them were Staphylococcus aureus and Staphylococcus epidermidis. Gram-negative bacteria were 86 strains (59.31%), main of them were Escherichia coli, Enterobacter cloacae, Bacillus proteus, and Klebsiella pneumoniae. Gram-positive bacteria were sensitive to vancomycin, linezolid, tigecycline, moxifloxacin, rifampin, and levofloxacin. Gram-negative bacteria were sensitive to imipenem, meropenem, cefoperazone/sulbactam, piperacillin/tazobactam, and amikacin. Conclusion For diabetic foot patients, especially those with higher Wagner grades, etiological examination and antimicrobial susceptibility testing of ulcer secretion should be timely performed, so as to provide reference for rational use of antimicrobial agents in clinic.