德黑兰轻、中、重度糖尿病足感染患者的微生物谱及抗生素药敏模式。

Microbial Profile and Antibiotic Susceptibility Pattern in Diabetic Patients with Mild, Moderate, and Severe Foot Infections in Tehran.

机构信息

Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Razi Inst. 2022 Oct 31;77(5):1925-1933. doi: 10.22092/ARI.2022.359759.2476. eCollection 2022 Oct.

Abstract

It is estimated that 10-25% of diabetic patients will encounter diabetic foot ulcers (DFU) during their lifetime. This study evaluated the microbiology of DFUs and determined the antibiotic resistance pattern of bacterial isolates based on the severity of wounds and infections in different grades of ulcer. The specimens were collected from115 diabetic foot infections (DFI) deep tissue by needle aspiration and biopsy. The aerobic and anaerobic cultures and antimicrobial susceptibility testing were carried out. The presence of resistance genes including metallo-beta-lactamases (MBL), extended-spectrum β-lactamase (ESBL), , , and was also determined. A total of 222 microorganisms were isolated. The prevalence of poly-microbial infections was 69.6%. Bacterial isolates comprised 64.2% Gram-positive bacteria (GPB), 33.5% Gram-negative bacteria (GNB), and five isolates of anaerobic bacteria were also detected. The most prevalent GPB and GNB were . (52.2%) and (33.3%), respectively. The prevalence of poly-microbial infections and GNB was positively associated with increased grades of Wagner and IDSA classifications. Among isolates, resistance to clindamycin (73.5%), ciprofloxacin (70.6%), and erythromycin (70.6%) were noticeable. GNB was also highly resistant to cephalosporins and ciprofloxacin. ESBL genes were detected in approximately 40% of isolates of Enterobacteriaceae. The prevalence of , , and genes in isolates were 8.8%, 32.3%, and 14.7%, respectively. In conclusion, our data suggest that GPBs are the most common isolates from DFIs. Furthermore, with the development of wounds and infection, the prevalence of GNB in DFIs are increased.

摘要

据估计,10-25%的糖尿病患者在其一生中会遭遇糖尿病足溃疡(DFU)。本研究评估了 DFU 的微生物学,并根据溃疡严重程度和不同等级感染确定了细菌分离株的抗生素耐药模式。通过针吸和活检从 115 例糖尿病足感染(DFI)深部组织采集标本。进行了需氧和厌氧培养以及抗菌药物敏感性试验。还确定了包括金属β-内酰胺酶(MBL)、超广谱β-内酰胺酶(ESBL)、 、 和 在内的耐药基因的存在。共分离出 222 种微生物。多微生物感染的患病率为 69.6%。细菌分离株包括 64.2%的革兰氏阳性菌(GPB)、33.5%的革兰氏阴性菌(GNB),还检测到五株厌氧菌。最常见的 GPB 和 GNB 分别为 (52.2%)和 (33.3%)。多微生物感染和 GNB 的患病率与 Wagner 和 IDSA 分类等级的增加呈正相关。在 分离株中,对克林霉素(73.5%)、环丙沙星(70.6%)和红霉素(70.6%)的耐药性较为明显。GNB 对头孢菌素和环丙沙星也高度耐药。大约 40%的肠杆菌科分离株检测到 ESBL 基因。在 分离株中, 、 和 基因的流行率分别为 8.8%、32.3%和 14.7%。总之,我们的数据表明,DFI 最常见的分离株是 GPB。此外,随着伤口和感染的发展,DFI 中 GNB 的患病率增加。

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