论文部分内容阅读
目的:分析糖尿病足感染病原菌及药敏检查结果指导抗生素运用情况,为选择最优的抗感染方案提供参考。方法:收集、对比某医院内分泌科2012年6月-2013年6月糖尿病足分泌物病原菌培养及药敏结果的处理情况,发现其中的问题并进行探讨与分析。结果:糖尿病足分泌物感染革兰阳性菌以金黄色葡萄球菌、溶血葡萄球菌、类香味菌为主;革兰阴性菌以鲍曼不动杆菌、大肠埃希菌、变形杆菌为主。以金黄色葡萄球菌耐药情况尤为突出。常用抗生素以氨曲南、左氧氟沙星、头孢哌酮/他唑巴坦为主。临床运用抗生素时药敏试验的覆盖率达51.56%,未做细菌培养及药敏试验的患者多以病情较轻(0~1级)或无分泌物为主。药敏结果敏感占78.15%,耐药占12.58%,中介占5.96%。预后良好占93.38%,预后不好占6.62%。结论:糖尿病足感染的患者在该院临床抗生素使用及预后结果情况较好。由于影响糖尿病足感染的病原菌及药敏的因素是多方面的,认真地对待每一个细节是提高疗效的基础,尤其是处理好“耐药”“中介”情况下抗生素的调整。
Objective: To analyze the pathogen of diabetic foot infection and drug susceptibility test results to guide the use of antibiotics, in order to choose the best anti-infective programs provide a reference. Methods: To collect and compare the treatment of pathogenic bacteria of diabetic foot secretions and drug susceptibility in endocrinology department of a hospital from June 2012 to June 2013, and find the problems and discuss and analyze. Results: Staphylococcus aureus, Staphylococcus haemolyticus and aroma-like bacteria were the main pathogens of gram-positive bacteria in diabetic foot secretion. Gram-negative bacteria were Acinetobacter baumannii, Escherichia coli and Proteus. Staphylococcus aureus drug resistance is particularly prominent. Commonly used antibiotics aztreonam, levofloxacin, cefoperazone / tazobactam based. The coverage rate of antibiotic susceptibility test was 51.56% when antibiotics were used clinically. Most of the patients who did not make bacterial culture and susceptibility test were mostly mild (grade 0 ~ 1) or no secretions. Sensitivity of drug sensitivity accounted for 78.15%, drug resistance accounted for 12.58%, intermediary accounted for 5.96%. Good prognosis accounted for 93.38%, poor prognosis accounted for 6.62%. Conclusion: Patients with diabetic foot infection in the hospital clinical antibiotics and prognosis of the situation is better. Because of the many factors influencing the pathogens and susceptibility of diabetic foot infections, careful treatment of every detail is the basis for improving the curative effect, especially the adjustment of antibiotics in case of “resistant” “intermediary ”.