Martínez-Gómez Diego de Alcalá, Ramírez-Almagro Cristóbal, Campillo-Soto Alvaro, Morales-Cuenca Germán, Pagán-Ortiz Jorge, Aguayo-Albasini José Luis
Servicio de Cirugía General y Digestiva, Hospital General Universitario José María Morales Meseguer, Murcia, España.
Enferm Infecc Microbiol Clin. 2009 Jun;27(6):317-21. doi: 10.1016/j.eimc.2008.07.004. Epub 2009 Feb 23.
Foot infections are a common reason for hospitalization and a cause of complications in patients with diabetes. The aim of this study was to determine the prevalence of microorganisms found on culture in complicated diabetic foot infections in hospitalized patients, and the sensitivity of the causative microorganisms to antimicrobial agents.
Between December 2001 and December 2005 in our department, 84 samples in 62 diabetic patients with moderate/severe infection were collected for microbiological study.
At least one microorganism was isolated in 88% of samples. The most frequently isolated germ group was gram-positive bacteria (55% of the samples), with Staphylococcus aureus (33%) in the first position, followed by Pseudomonas aeruginosa (12%), Enterococcus spp. (9%), and Escherichia coli (8%). Culture for anaerobic microorganisms was only performed in half the samples; 25% were positive, and Peptostreptococcus spp. predominated. Among the multiresistant microorganisms, methicillin-resistant staphylococci aureus (MRSA) were the most common, accounting for 38% of the isolated strains of S. aureus, ie, 12% of all samples. As to the gram-negative microorganisms, nearly 30% of E. coli strains were resistant to amoxicillin/clavulanic acid and ciprofloxacin.
Most of the cultures in our study were monomicrobial, with S. aureus being the most prevalent microorganism, followed by enterobacteria and P. aeruginosa. The main resistant microorganism in diabetic foot infections requiring hospitalization was methicillin-resistant golden staphylococcus, which was found in 12% of the series.
足部感染是住院治疗的常见原因，也是糖尿病患者并发症的一个成因。本研究的目的是确定住院患者复杂糖尿病足感染培养物中发现的微生物的患病率，以及致病微生物对抗菌药物的敏感性。
2001年12月至2005年12月期间，在我们科室，收集了62例中度/重度感染糖尿病患者的84份样本进行微生物学研究。
88%的样本中至少分离出一种微生物。最常分离出的菌群是革兰氏阳性菌（占样本的55%），其中金黄色葡萄球菌（占33%）位居首位，其次是铜绿假单胞菌（占12%）、肠球菌属（占9%）和大肠杆菌（占8%）。仅对一半的样本进行了厌氧微生物培养；25%呈阳性，以消化链球菌属为主。在多重耐药微生物中，耐甲氧西林金黄色葡萄球菌（MRSA）最为常见，占分离出的金黄色葡萄球菌菌株的38%，即占所有样本的12%。至于革兰氏阴性微生物，近30%的大肠杆菌菌株对阿莫西林/克拉维酸和环丙沙星耐药。
我们研究中的大多数培养物为单一微生物感染，金黄色葡萄球菌是最常见的微生物，其次是肠杆菌和铜绿假单胞菌。需要住院治疗的糖尿病足感染中的主要耐药微生物是耐甲氧西林金黄色葡萄球菌，在该系列病例中占12%。
