糖尿病足感染：阿曼一家三级护理医院细菌分离株的概况及抗生素敏感性模式
Diabetic foot infections: Profile and antibiotic susceptibility patterns of bacterial isolates in a tertiary care hospital of Oman.
作者信息
Sannathimmappa Mohan Bilikallahalli, Nambiar Vinod, Aravindakshan Rajeev, Al Khabori Mohammad Saleem Jawad, Al-Flaiti Asma Hamed Sulaiman, Al-Azri Kadhiya Nasser Mohamed, Al-Reesi Ali Khamis Saif, Al Kiyumi Alya Rashid Mohammad
机构信息
Department of Microbiology, College of Medicine and Health Sciences, Sohar Campus, National University of Science and Technology, Oman.
Department of Community Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.
出版信息
J Educ Health Promot. 2021 Jul 30;10:254. doi: 10.4103/jehp.jehp_1552_20. eCollection 2021.
BACKGROUND
In diabetic foot infections (DFIs), the diversity of microbial profile and ever-changing antibiotic-resistance patterns emphasize accurate characterization of microbial profile and antibiotic susceptibility pattern. The aim of the study was to investigate the pathogens associated with DFI and their antibiotic susceptibility patterns.
MATERIALS AND METHODS
A cross-sectional retrospective study was conducted at a tertiary-care hospital, Oman. The socio-demographic and microbiological profile and antibiotic susceptibility patterns of pathogens isolated from patients with DFIs from January 2013 to December 2018 were reviewed. Quantitative and qualitative variables were expressed as mean ± standard deviation and percentages, respectively. A Chi-square test was used for testing the association between multidrug-resistant (MDR) organisms and variables.
RESULTS
In total, 233 isolates recovered from 133 clinical specimens with an average of 1.8 organisms per specimen were included in the study. Fifty-six and forty-four percent of specimens showed monomicrobial and polymicrobial growth of two or more organisms, respectively. The frequency of isolation was predominant among males (65%). Aerobic Gram-negative rods were predominantly (75%) isolated compared to Gram-positive organisms (25%). and were the most frequently isolated Gram-positive and Gram-negative bacteria, respectively. Thirty-eight percent of them were MDR strains. Gram-negative organisms showed fairly good susceptibility ranging from 75% to 100% to carbapenems, aminoglycosides, and piperacillin-tazobactam. While doxycycline and trimethoprim-sulfamethoxazole showed good susceptibility toward Gram-positive organisms.
CONCLUSION
DFIs are often polymicrobial with a predominance of Gram-negative pathogens. This study recommends the use of carbapenems and doxycycline for empirical therapy of Gram-negative and Gram-positive bacterial DFIs, respectively.
背景
在糖尿病足感染（DFI）中，微生物谱的多样性和不断变化的抗生素耐药模式强调了对微生物谱和抗生素敏感性模式进行准确表征。本研究的目的是调查与DFI相关的病原体及其抗生素敏感性模式。
材料与方法
在阿曼的一家三级医院进行了一项横断面回顾性研究。回顾了2013年1月至2018年12月从DFI患者中分离出的病原体的社会人口统计学和微生物学特征以及抗生素敏感性模式。定量和定性变量分别表示为平均值±标准差和百分比。采用卡方检验来检验多重耐药（MDR）菌与变量之间的关联。
结果
本研究共纳入了从133份临床标本中分离出的233株菌株，每份标本平均分离出1.8种微生物。分别有56%和44%的标本显示单一微生物生长以及两种或更多种微生物的多微生物生长。分离频率在男性中占主导（65%）。与革兰氏阳性菌（25%）相比，需氧革兰氏阴性杆菌的分离率更高（75%）。金黄色葡萄球菌和大肠埃希菌分别是最常分离出的革兰氏阳性菌和革兰氏阴性菌。其中38%为MDR菌株。革兰氏阴性菌对碳青霉烯类、氨基糖苷类和哌拉西林 - 他唑巴坦的敏感性相当高，范围在75%至100%之间。而多西环素和复方新诺明对革兰氏阳性菌显示出良好的敏感性。
结论
DFI通常是多微生物感染，革兰氏阴性病原体占主导。本研究建议分别使用碳青霉烯类和多西环素对革兰氏阴性菌和革兰氏阳性菌引起的DFI进行经验性治疗。
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