Noviello Silvana, Esposito Isabella, Pascale Renato, Esposito Silvano, Zeppa Pio
UOD Medicina Infettivologica, Dipartimento di Medicina e Chirurgia, Universita di Salerno, Italy.
Infez Med. 2012;20 Suppl 1:20-7.
The diagnosis of wound infection is based on clinical signs and local and/or systemic inflammation. Therefore, the examination has a major role in the diagnosis of infected lesions of the foot. Once the clinical diagnosis of infection is made, the next step is to determine the etiology with the aim to undertake a rational and appropriate treatment. The most reliable method for assessing microbiological etiology is the specimen of material from infected lesion to perform a bacterioscopic examination and culture. The microorganisms involved in the etiology of diabetic foot depends on the type of injury and on specific patient features (antibiotic therapy, previous hospitalization). The most frequently detected pathogen is Staphylococcus aureus. Mild infections are mostly caused by Gram positive cocci, with a prevalence of S. aureus. Moderate infections are mostly supported by pyogenic Gram positive cocci, but also Gram-negative bacteria can be involved. In severe infections the etiology is polymicrobial. As regards the involvement of fungi in diabetic foot infections data are few and mostly conflicting.
伤口感染的诊断基于临床症状以及局部和/或全身炎症。因此，检查在足部感染性病变的诊断中起着重要作用。一旦做出感染的临床诊断，下一步就是确定病因，以便进行合理且恰当的治疗。评估微生物病因的最可靠方法是从感染病变处采集样本进行细菌学检查和培养。糖尿病足病因中涉及的微生物取决于损伤类型和特定患者特征（抗生素治疗、既往住院情况）。最常检测到的病原体是金黄色葡萄球菌。轻度感染大多由革兰氏阳性球菌引起，以金黄色葡萄球菌为主。中度感染大多由化脓性革兰氏阳性球菌引起，但革兰氏阴性菌也可能参与其中。在严重感染中，病因是多微生物的。关于真菌在糖尿病足感染中的参与情况，数据较少且大多相互矛盾。
