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| DOI： |
| 中文关键词: 糖尿病足 感染 细菌 耐药性，海南省 |
| 英文关键词:Diabetic foot, Infection, Bacteria, Drug resistance,Hainan Province.. |
| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
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| 中文摘要: |
| 目的 探讨海南地区糖尿病足感染（DFI）患者细菌谱，并对其耐药性进行分析。方法 收集了海南医学院第一附属医院2018年1月份至2020年1月份期间224例DFI患者的一般资料，并对其创面分泌物细菌培养及药敏试验结果进行回顾性分析。
结果 一共有248份标本培养出病原菌，其中革兰阳性菌123例（49.60%）、革兰阴性菌150例（60.48%）、真菌39例（15.73%）。金黄色葡萄球菌（18.55%）、粪肠球菌（7.66%）、无乳链球菌（3.23%）、化脓性链球菌（2.42%）占革兰阳性菌中前4位。大肠埃希氏菌（6.05%）、铜绿假单胞菌（14.86%）、奇异变形杆菌（8.47%）和肺炎克雷伯菌（6.85%）占革兰氏阴性菌中前4位。真菌主要有白色念珠菌（8.87%）、光滑念珠菌（3.63%）和近平滑念珠菌（3.23%）。耐药性分析提示本组患者金黄色葡萄球菌对四环素的耐药高达52.17%，粪肠球菌对四环素耐药达94.74%。葡萄球菌感染应选择莫西沙星、氨苄西林、高水平庆大霉素协同、万古霉素；大肠埃希菌感染应选择头孢吡肟、头孢他啶、头孢曲松或头孢呋辛氯霉素；铜绿假单胞菌感染应选择左氧氟沙星、头孢唑啉、头孢吡肟、氯霉素治疗。结论 海南地区DFI患者病原菌种类繁多，以革兰氏阴性菌为主，且对常规抗生素都有一定的耐药现象。应加强DFI患者细菌谱和耐药性检测分析，可为海南地区DFI患者防治提供合理的理论依据。 |
| 英文摘要: |
| Objective: To analysis the characteristics and drug resistance of pathogenic bacteria in patients with diabetic foot infection(DFI) in Hainan region.Methods: A retrospective study was carried out on 149 DFI patients from The First Affiliated Hospital of Hainan Medical University from January 2018 to January 2020 , and the results of bacterial culture and drug sensitivity test were analyzed.Results: A total of 248 specimens were cultured for positive,49.60% were Gram positive(G+) bacteria,60.48% were Gram negative(G-) bacteria and 15.73% were fungi infection. Staphylococcus aureus(18.55%),Enterococcus faecalis(7.66%) and Suppurative streptococci(2.42%) were the major aerobicbacteria in Gram positive(G+) bacteria. Escherichia coli (6.05%), Pseudomonas aeruginosa (14.86%) and Klebsiella pneumoniae (6.85%) were the major aerobicbacteria in Gram-negative bacteria. The main fungi were candida albicans (8.87%), candida lucidum (3.63%) and candida lucidum (3.23%).Drug resistance analysis indicated that the drug resistance of staphylococcus aureus to penicillin G in this group was as high as 36.96%, and that of enterococcus faecalis to erythromycin was up to 84.21%.For staphylococcal infection, moxifloxacin, ampicillin, high level gentamicin synergism and vancomycin should be selected.Cefepime, ceftazidime, ceftriaxone or cefuroxime should be selected for escherichia coli infection.Ampicillin, cefazolin, cefepime and ceftriaxone should be selected to treat pseudomonas aeruginosa infection. Conclusions: DFI patients in Hainan have a wide variety of pathogenic bacteria, mainly gram-negative bacteria, and have certain resistance to conventional antibiotics.The bacterial spectrum and drug resistance detection analysis of DFI patients should be strengthened to provide a reasonable theoretical basis for the prevention and treatment of DFI patients in Hainan province. |
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