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在比尔医院糖尿病足感染中分离出的常见病原体。

Common pathogens isolated in diabetic foot infection in Bir Hospital.

作者信息

Sharma V K, Khadka P B, Joshi A, Sharma R

机构信息

General Surgery Unit III, Bir Hospital NAMS, Mahaboudha Kathmandu, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2006 Jul-Sep;4(3):295-301.

Abstract

AIM

Foot ulcers are a frequent complication of patients suffering with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admission . Secondary infection of these ulcers is by far the leading cause of amputation of feet and legs and the polymicrobial nature of diabetic foot infection has been well documented in the literature. The present study sought to reveal the bacterial etiology of diabetic foot ulcer in patients presenting to Bir Hospital.

METHOD

A 1 year retrospective study was carried out to analyse the bacterial isolates of all patients admitted with diabetic foot infection presented with Wagner grade 2 -5 ulcers. Bacteriological diagnosis and antibiotic sensitivity profiles were carried out and analysed using standard procedures.

RESULTS

Diabetic polyneuropathy was found to be common in (51.1%) and gram positive bacteria were isolated more often than gram-negative ones in the patients screened. The most frequent bacterial isolate were Staphylococcus aureus (38.4%), Pseudomonas aeruginosa (17.5%), and Proteus (14%). Imipenem was the most effective agent against gram-negative organisms. Vancomycin was found to be most effective against gram-positive organisms.

CONCLUSION

Staph aureus and Pseudomonas aeruginosa were the most common causes of diabetic foot infections in Bir Hospital. Theses wounds require use of combined antimicrobial therapy for initial management, repeated dressing and wound debridements were done.

摘要

目的

足部溃疡是糖尿病患者常见的并发症,占糖尿病相关住院病例的20%。这些溃疡的继发感染是目前足部和腿部截肢的主要原因,糖尿病足感染的微生物特性在文献中已有充分记载。本研究旨在揭示比尔医院糖尿病足溃疡患者的细菌病因。

方法

进行了一项为期1年的回顾性研究,分析所有因糖尿病足感染入院且患有瓦格纳2-5级溃疡的患者的细菌分离株。采用标准程序进行细菌学诊断和抗生素敏感性分析。

结果

在筛查的患者中,糖尿病多发性神经病变常见(51.1%),革兰氏阳性菌的分离率高于革兰氏阴性菌。最常见的细菌分离株是金黄色葡萄球菌(38.4%)、铜绿假单胞菌(17.5%)和变形杆菌(14%)。亚胺培南是对抗革兰氏阴性菌最有效的药物。万古霉素被发现对革兰氏阳性菌最有效。

结论

金黄色葡萄球菌和铜绿假单胞菌是比尔医院糖尿病足感染的最常见原因。这些伤口初始处理需要联合使用抗菌治疗,并进行反复换药和伤口清创。

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