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巴基斯坦卡拉奇一家三级护理医院糖尿病足感染患者的感染微生物模式及其对抗菌药物的敏感性

Pattern of Infecting Microorganisms and Their Susceptibility to Antimicrobial Drugs in Patients with Diabetic Foot Infections in a Tertiary Care Hospital in Karachi, Pakistan.

作者信息

Kaimkhani Ghulam M, Siddiqui Adeel A, Rasheed Nusrat, Rajput Mohammad Irfan, Kumar Jagdesh, Khan Mohammad Hassan, Nisar Shahzadi, Mustafa Sheema, Yaqoob Uzair

机构信息

Orthopedic Surgery, Dow University of Health Sciences, Karachi, PAK.

Orthopaedic Surgery, Dow University of Health Sciences, Karachi, PAK.

出版信息

Cureus. 2018 Jun 25;10(6):e2872. doi: 10.7759/cureus.2872.

Abstract

Diabetes mellitus is a universal health problem, with its prevalence in Pakistan making it among the top 10 countries in the world. Approximately 13.9 million people in Pakistan will have developed diabetes by 2030. Diabetic foot ulcer (DFU) is one of the more serious complications of diabetes. If not treated properly, patients may develop diabetic foot osteomyelitis leading to gangrene and amputation. These infections are usually polymicrobial, with Staphylococcus aureus (S. aureus), Proteus, Pseudomonas, and Escherichia coli (E. coli) being among the more common organisms isolated from DFU. This survey of patients with DFU in a tertiary hospital in Karachi, Pakistan found 68.5% of patients had peripheral neuropathy, 57% had chronic osteomyelitis, and 37% and 49% had Wagner grades 2 and 3, respectively. Infections were polymicrobial in 83% of patients, E. coli was isolated from 63%, and S. aureus from 58%. Of the isolated organisms, 95% were sensitive to meropenem and 81% to linezolid.

摘要

糖尿病是一个全球性的健康问题,其在巴基斯坦的患病率使其成为世界上糖尿病患病率排名前十的国家之一。到2030年,巴基斯坦约有1390万人将患糖尿病。糖尿病足溃疡(DFU)是糖尿病较为严重的并发症之一。如果治疗不当,患者可能会发展为糖尿病足骨髓炎,导致坏疽和截肢。这些感染通常是多微生物感染,从糖尿病足溃疡中分离出的较常见微生物包括金黄色葡萄球菌(S. aureus)、变形杆菌、铜绿假单胞菌和大肠杆菌(E. coli)。在巴基斯坦卡拉奇一家三级医院对糖尿病足溃疡患者进行的这项调查发现,68.5%的患者患有周围神经病变,57%的患者患有慢性骨髓炎,37%和49%的患者分别处于瓦格纳2级和3级。83%的患者感染是多微生物感染,63%的患者分离出大肠杆菌,58%的患者分离出金黄色葡萄球菌。在分离出的微生物中,95%对美罗培南敏感,81%对利奈唑胺敏感。

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N Engl J Med. 2017 Jun 15;376(24):2367-2375. doi: 10.1056/NEJMra1615439.
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The microbiome of diabetic foot osteomyelitis.糖尿病足骨髓炎的微生物群
Eur J Clin Microbiol Infect Dis. 2016 Feb;35(2):293-8. doi: 10.1007/s10096-015-2544-1. Epub 2015 Dec 15.
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Diabetic foot infections.糖尿病足感染。
Am Fam Physician. 2013 Aug 1;88(3):177-84.
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Diabetic foot infections: current concept review.糖尿病足感染:当前概念综述
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