Distribution and antibiotic susceptibility of pathogens in diabetic foot infection based on Wagner grade

Zhao Liang; Cheng Qingfeng; Zhu Shenyin; Xiang Yi; Li Xinyu; Qiu Feng; Li Qifu; Liu Yu

doi:10.13406/j.cnki.cyxb.001051

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Distribution and antibiotic susceptibility of pathogens in diabetic foot infection based on Wagner grade

更新时间：2024-01-17

- Distribution and antibiotic susceptibility of pathogens in diabetic foot infection based on Wagner grade
- Journal of Chongqing Medical University Vol. 41, Issue 11, Pages: 1105-1109(2016)
- 作者机构：
  
  1. 重庆医科大学附属第一医院药学部
  2. 重庆医科大学附属第一医院内分泌科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001051
  CLC： R587.2
- Published：2016，
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[1]赵亮,程庆丰,朱深银,向翼,李欣宇,邱峰,李启富,刘宇.基于Wagner分级糖尿病足感染的病原菌分布及药敏分析[J].重庆医科大学学报,2016,41(11):1105-1109.

Zhao Liang, Cheng Qingfeng, Zhu Shenyin, et al. Distribution and antibiotic susceptibility of pathogens in diabetic foot infection based on Wagner grade. [J]. Journal of Chongqing Medical University 41(11):1105-1109(2016)
[1]赵亮,程庆丰,朱深银,向翼,李欣宇,邱峰,李启富,刘宇.基于Wagner分级糖尿病足感染的病原菌分布及药敏分析[J].重庆医科大学学报,2016,41(11):1105-1109. DOI： 10.13406/j.cnki.cyxb.001051.

Zhao Liang, Cheng Qingfeng, Zhu Shenyin, et al. Distribution and antibiotic susceptibility of pathogens in diabetic foot infection based on Wagner grade. [J]. Journal of Chongqing Medical University 41(11):1105-1109(2016) DOI： 10.13406/j.cnki.cyxb.001051.

摘要

目的:调查基于Wagner分级糖尿病足感染（diabetic foot infection

DFI）的病原菌分布及药敏情况。方法:回顾性调查重庆医科大学附属第一医院2014年1月至2016年1月收治的216例DFI患者

统计分析不同Wagner分级的DFI患者病足溃疡标本中培养的病原菌分布、多重耐药（multiple drug resistance

MDR）菌构成及其药敏结果。结果:分离出病原菌263株:单菌感染占57.4%

混合菌感染占42.6%;革兰阳性（G+）菌、革兰阴性（G-）菌和真菌分别占43.5%、48.1%和8.4%。Wagner分级患足细菌培养结果显示:2级:G+菌45株

金黄色葡萄球菌占48.9%

G-菌43株

肠杆菌占69.8%;3级:G+菌36株

肠球菌占47.2%

金黄色葡萄球菌占27.8%

G-菌44株

肠杆菌占72.7%;4级:G+菌24株

肠球菌占33.3%

金黄色葡萄球菌占25.0%

链球菌占25.0%

G-菌23株

肠杆菌占73.9%;5级:G+菌9株

肠球菌占66.7%

G-菌16株

肠杆菌占81.3%。不同Wagner分级患者G+菌和G-菌分布情况无统计学差异（P=0.526）。G+菌对万古霉素、利奈唑胺、莫西沙星、替加环素敏感性达75%以上

G-菌对碳青霉烯类、阿米卡星、抗假单胞菌青霉素类复方制剂、四代头孢菌素类、头霉素类敏感性达64%以上。结论:DFI患者总体上单一菌略多于混合菌感染

G-菌较G+菌感染分布略占优势。G+菌及G-菌对常用的抗G+菌及G-菌药物有较好敏感性。

Abstract

Objective:To investigate the distribution and antibiotic susceptibility of pathogens in diabetic foot infection(DFI) based on Wagner grade. Methods:Totally 216 patients of DFI in the First Affiliated Hospital of Chongqing Medical University were investigated retrospectively from January 2014 to January 2016. The distribution and antibiotic susceptibility of pathogens and multiple drug resistance(MDR)bacteria in foot ulcers cultured specimens based on patients with different Wagner grades of DFI were statistically analyzed. Results:A total of 263 strains of pathogenic bacteria were isolated:single bacterial infection accounting for 57.4%

mixed infection accounting for 42.6%

gram-postive bacteria accounting for 43.5%

gram-negative bacteria accounting for 48.1%

fungi accounting for 8.4%. The results of bacteria culture in different Wagner grades of foot ulcers showed :Wagner grade 2:45 strains of gram-postive bacteria

Staphylococcus aureus(48.9%)

43 strains of gram-negative

Enterobacter(69.8%). Wagner grade 3:36 strains of gram-postive bacteria

Enterococcus(47.2%)

Staphylococcus aureus(27.8%);44 strains of gram-negative

Enterobacter(72.7%).Wagner grade 4:24 strains of gram-postive bacteria

Staphylococcus aureus(25%)

Enterococcus(33.3%)

Striptococcus(25%);23 strains of gram-negative

Enterobacter(73.9%). Wagner grade 5:5 strains of gram-postive bacteria

enterococcus(66.7%);16 strains of gramnegative bacteria

Enterobacter(81.3%). There is no statistically significant difference in the distribution of gram-postive bacteria and gram-negative bacteria in different Wagner grades(P=0.526). Gram-postive bacteria are susceptible to vancomycin

linezolid

moxifloxacin and tigecyclin

more than 75%. Gram-negative bacteria are susceptible to carbapenems

amikacin

compound preparation of anti pseudomonas penicillin

four generation of cephalosporins and cephamycins

more than 64%. Conclusion:In patients of DFI

in general a single bacterial infection was slightly more than mixed bacterial infection;the distribution of gram-negative bacteria is slightly dominant over the distribution of gram-postive bacteria. Gram-postive bacteria and gram-negative bacteria have good sensitivity to anti gram-postive and gram-negative bacteria antibiotics commonly used.

关键词

糖尿病足感染Wagner分级病原菌多重耐药药敏

Keywords

diabetic foot infectionWagner gradepathogenmultidrug-resistantantibiotic susceptibility

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