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感染性糖尿病足的细菌学特征及抗生素耐药情况。

Bacteriological profile and frequency of antibiotic resistance in the infected diabetic foot.

机构信息

Department of Pharmacy, Faculty of Medical Sciences, University of Batna2, 05000, Algeria.

出版信息

Cell Mol Biol (Noisy-le-grand). 2023 May 31;69(5):143-149. doi: 10.14715/cmb/2023.69.5.22.

Abstract

The diabetic foot (DF) is a major public health problem, with infection of the DF being a major risk factor for amputation. This study aimed to establish the bacteriological profile of diabetic foot infection and to evaluate the resistance of isolated bacteria to antibiotics. Retrospective study of 150 patients in the internal medicine departments of the University Hospital of Batna, the University Hospital of Constantine and the EPH of Oum El Bouaghi, over 24 months from September 2019 to August 2021. The population had an average age of 46±13 years and a sex ratio of 1.88 in favour of men. The majority of patients were type 2 diabetics with a mean duration of the evolution of 20 years. The starting point of the foot lesions was inter-toe intertrigo and trauma. The most frequent lesion found was an infectious lesion followed by gangrene, classified in 33.64% of cases as Grade 2 according to Wagner. We performed a swab of the ulcer, and direct examination showed a predominance of Gram-negative bacilli (GNB) in 78.56% of the samples, 17 different bacterial species were isolated, predominantly Escherichia coli and Pseudomenas aeruginosa. We studied the antibiotic resistance of the most frequently isolated bacteria, the antibiotic therapy was initially probabilistic and then adapted to the antibiogram. The multidisciplinary management of diabetic foot is still very precarious, and the best treatment is prevention.

摘要

糖尿病足(DF)是一个重大的公共卫生问题,DF 感染是导致截肢的主要危险因素。本研究旨在确定糖尿病足感染的细菌学特征,并评估分离细菌对抗生素的耐药性。这是一项在 2019 年 9 月至 2021 年 8 月的 24 个月内,对巴特纳大学医院、君士坦丁大学医院和奥姆布瓦吉 EPH 的内科部门的 150 名患者进行的回顾性研究。该人群的平均年龄为 46±13 岁,男女比例为 1.88。大多数患者为 2 型糖尿病患者,病程平均为 20 年。足部病变的起点是趾间擦烂和创伤。最常见的病变是感染性病变,其次是坏疽,根据 Wagner 分类,33.64%的病例为 2 级。我们对溃疡进行了拭子取样,直接检查显示 78.56%的样本中革兰氏阴性杆菌(GNB)占优势,分离出 17 种不同的细菌,其中以大肠杆菌和绿脓假单胞菌为主。我们研究了最常分离的细菌的抗生素耐药性,最初的抗生素治疗是基于概率的,然后根据药敏试验结果进行调整。糖尿病足的多学科管理仍然非常不稳定,最好的治疗方法是预防。

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