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目的探讨引起糖尿病足患者多重耐药菌感染的相关因素。方法对2008年5月-2011年5月在某院就诊的83例MDRMs感染的糖尿病足(DF)患者进行分析,选择同期未感染的83例DF患者和其进行匹配,找到引起MDRMs感染的相关因素。结果83例患者共分离出123株MDRMs,以金黄色葡萄球菌为首(40.65%),其后依次为铜绿假单胞菌(25.20%)和肠杆菌(21.14%)。革兰阴性菌占54.47%,革兰阳性菌占45.53%。多因素Logistic回归分析结果显示,使用抗生素(OR1.75,95%CI1.382.21)、抗生素治疗疗程(OR3.53,95%CI1.587.87)、住院次数(OR2.10,95%CI1.123.92)、合并骨髓炎(OR5.81,95%CI2.9311.54)、使用三代头孢(OR1.54,95%CI1.102.15)和神经缺损性伤口(OR4.81,95%CI1.4016.52)与MDRMs感染有着密切关系。结论使用抗生素、抗生素治疗疗程、住院次数、合并骨髓炎、使用三代头孢和神经缺损性伤口与MDRMs感染有着密切关系。
Objective To investigate the related factors of multiple drug-resistant bacterial infections in patients with diabetic foot. Methods 83 patients with diabetic foot (DF) infected with MDRMs in a hospital from May 2008 to May 2011 were analyzed. 83 uninfected DF patients were matched with DF patients in the same period to find out the correlations between MDRMs infection factor. Results A total of 123 MDRMs were isolated from 83 patients, with Staphylococcus aureus (40.65%) followed by Pseudomonas aeruginosa (25.20%) and Enterobacter cloacae (21.14%). Gram-negative bacteria accounted for 54.47%, Gram-positive bacteria accounted for 45.53%. Multivariate logistic regression analysis showed that antibiotic treatment (OR3.53, 95% CI 1.587.87), hospitalization (OR2.10, 95% CI 1.123.92), antibiotic treatment (OR1.75,95% CI1.382.21) , With osteomyelitis (OR5.81,95% CI2.9311.54), infected with MDRMs using third generation cephalosporins (OR 1.54, 95% CI 1.102.15) and nerve deficient wounds (OR 4.81, 95% CI 1.4016.52) close relationship. Conclusion The use of antibiotics, antibiotic treatment courses, hospitalizations, combined with osteomyelitis, the use of third-generation cephalosporins and nerve-deficient wounds and MDRMs infection are closely related.