糖尿病足感染的细菌学特点与预后分析

目的了解糖尿病足感染的细菌学特点及其耐药性，并分析糖尿病足分级、其缺血与否与感染细菌的菌种及预后的相关性。方法取52例糖尿病足感染患者足部分泌物进行常规细菌培养和药敏试验。结果52例糖尿病足分泌物标本细菌培养获阳性结果46例，阴性结果6例。共检出需氧菌20种，菌株61株，革兰阳性球菌30株，以表皮葡萄球菌、金黄色葡萄球菌、粪肠球菌多见，分别为12、6、5株；革兰阴性杆菌24株，以奇异变形杆菌、大肠埃希菌、阴沟肠杆菌多见，分别为8、6、4株；革兰阳性杆菌5株，念珠菌2株。其中有15份标本为混合性细菌感染，主要是表皮葡萄球菌与其他革兰阴性杆菌混合存在。本组糖尿病足分级与感染细菌的菌种无明显相关，与预后明显相关，其缺血与否与预后明显相关，但与菌群无明显相关。结论糖尿病足感染以葡萄球菌、奇异变形杆菌和大肠埃希菌多见，分别对万古霉素、亚胺培南最敏感。重视糖尿病足感染的细菌学特点及药敏试验结果，指导合理使用抗生素，提高糖尿病足感染治愈率，改善预后。

Analytic study on bacteriological features and drug resistance of infection in diabetic foot

Objective To study the bacteriological features and drug - resistance of infection in diabetic foot and investigate the correlation among grades of diabetic foot、ischemia、 bacteriology and curability. Method Common germicultrue and drug susceptibility test were conducted on the secretion collected from the feet of 52 patients with infection in diabetic foot. Results Among the 52 samples, 46 positive and 6 negative results were found . There were 20 aeromicrobe of 61 strains, including 30 strains of G ＋ coccus with staphylococcus epidermids 12 strains, staphylococcus aureus 6 strains, enterococcus faecalis 5 strains; 24 strains of G- bacillus with proteus mirabilis 8 strains, E. coli 6 strains, enterebacter cloacae 4 strains; 5 strains of G ＋ bacillus, 2 strains of candida. Among all these samples, 15 of them were mixed infections ,most of which were staphylococcus epidermids and other G- bacillus. Grades of diabetic foot and diabetic foot with ischemia or not were significantly correlated with curability , but not correlated with bacteriology. Conclusions Staphylococcus, proteus mirabilis and E. coli are predominant in diabetic foot infection , which are most sensitive to vancomycin and imipenem. We should pay attention to the bacteriological features and data of drug - resistant tests of infection in diabetic foot so as to use antibiotics rationally and increase the cure rate.