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糖尿病足感染患者的细菌分布、药敏变化及临床特征

Bacterial distribution, changes of drug susceptibility and clinical characteristics in patients with diabetic foot infection.

作者信息

Liu Ling, Li Zhihui, Liu Xinxin, Guo Shan, Guo Limin, Liu Xuelian

机构信息

Clinical Laboratory, Xinxiang Central Hospital, Xinxiang, Henan 453000, P.R. China.

Department of Hematology, Xinxiang Central Hospital, Xinxiang, Henan 453000, P.R. China.

出版信息

Exp Ther Med. 2018 Oct;16(4):3094-3098. doi: 10.3892/etm.2018.6530. Epub 2018 Jul 26.

Abstract

The present study aimed to investigate the bacterial distribution, changes in drug susceptibility and clinical characteristics in patients with diabetic foot infection (DFI). A retrospective analysis of 216 patients with DFI treated at Xinxiang Central Hospital between 2013 and 2016 was carried out to analyze the bacterial distribution, changes of susceptibility and clinical characteristics. A total of 262 pathogenic strains were isolated from 216 patients with DFI. Among them, 43.13% exhibited Gram-positive (G) bacteria, 45.04% exhibited Gram-negative (G) bacteria and 11.83% was other. Between 2013 and 2016, the susceptibility of pathogenic bacteria to common antibacterial drugs showed a declining trend year by year. G bacteria had high susceptibility to vancomycin and acetazolamide; while G bacteria showed high susceptibility to dibekacin, panipenem and biapenem. The main clinical symptoms of the 216 patients included edema (98.61%), purulent secretions (62.96%) and lower extremity sepsis (58.80%). The top three complications of the 216 cases were lower extremity vascular disease (58.80%), peripheral neuropathy (39.81%) and kidney disease (26.39%). Logistic regression analysis showed that age [odds ratio (OR), 2.708; P=0.005], previous use of antibacterial drugs (OR, 3.816; P=0.007) and application of the third generation cephalosporins (OR, 3.014; P=0.008) were the independent risk factors of drug resistance in patients with DFI (P<0.05). There were numerous types of pathogens in patients with DFI, and all of them had certain drug resistance. The drug susceptibility was decreasing year by year. The pathogens and drug resistance in patients with DFI should be monitored to reduce the incidence of related complications and improve the prognosis of patients.

摘要

本研究旨在调查糖尿病足感染(DFI)患者的细菌分布、药敏变化及临床特征。对2013年至2016年在新乡市中心医院接受治疗的216例DFI患者进行回顾性分析,以分析细菌分布、药敏变化及临床特征。从216例DFI患者中共分离出262株病原菌。其中,43.13%为革兰氏阳性(G⁺)菌,45.04%为革兰氏阴性(G⁻)菌,11.83%为其他菌。2013年至2016年,病原菌对常用抗菌药物的敏感性呈逐年下降趋势。G⁺菌对万古霉素和阿齐霉素敏感性高;而G⁻菌对硫酸奈替米星、帕尼培南和比阿培南敏感性高。216例患者的主要临床症状包括水肿(98.61%)、脓性分泌物(62.96%)和下肢败血症(58.80%)。216例患者的前三大并发症为下肢血管疾病(58.80%)、周围神经病变(39.81%)和肾脏疾病(26.39%)。Logistic回归分析显示,年龄[比值比(OR),2.708;P = 0.005]、既往使用抗菌药物(OR,3.816;P = 0.007)和应用第三代头孢菌素(OR,3.014;P = 0.008)是DFI患者耐药的独立危险因素(P < 0.05)。DFI患者病原菌种类繁多,均具有一定耐药性。药敏呈逐年下降趋势。应监测DFI患者的病原菌及耐药情况,以降低相关并发症的发生率,改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f47d/6125979/dc9e57f2207a/etm-16-04-3094-g00.jpg

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