| 刘林青,孟兰,吴新春,等.基于Wagner分级的糖尿病足感染患者病原菌分布与耐药性分析[J].中国临床保健杂志,2025,28(5):679-684. |
| 基于Wagner分级的糖尿病足感染患者病原菌分布与耐药性分析 |
| Pathogen distribution and drug resistance analysis of diabetic foot infection patients based on Wagner grading |
| 投稿时间：2025-08-10 |
| DOI：10.3969/J.issn.1672-6790.2025.05.019 |
| 中文关键词: 糖尿病足 抗药性,细菌 细菌感染 皮肤溃疡 抗菌药 |
| 英文关键词: Diabetic foot Drug resistance,bacterial Bacterial infections Skin ulcer Anti-bacterial agents 〖FL |
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| 中文摘要: |
| 目的 探讨糖尿病足感染(DFI)患者中,不同Wagner分级的病原菌分布及耐药性特征,为临床精准抗感染治疗提供依据。方法 回顾性分析2021年6月至2022年5月中国科学技术大学附属第一医院(安徽省立医院)收治的101例DFI患者的临床资料。依据Wagner分级将患者分为轻中度(2级)和重度(3/3+级),对分离出的病原菌进行种类鉴定及药敏试验。结果 共分离137株病原菌,其中革兰阳性菌(G+)69株(50.4%),以金黄色葡萄球菌(27株)、粪肠球菌(14株)、溶血葡萄糖球菌(5株)为主。革兰阴性菌(G-)68株(49.6%),以大肠埃希菌(9株)、肺炎克雷伯菌(8株)、铜绿假单胞菌(7株)、摩根摩根菌(7株)为主。Wagner 2级组G+菌占比61.9%,Wagner 3/3+级组G+菌占比45.3%。随Wagner分级升高,G+菌占比降低,多重耐药菌(MDRO)检出率升高。G+菌对万古霉素、替考拉宁、利奈唑胺敏感率100%；G-菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦敏感率100%。结论 DFI患者病原菌分布及耐药性与感染严重程度密切相关,且随着Wagner分级升高,G-菌占比及MDRO风险显著增加。 |
| 英文摘要: |
| Objective To explore the distribution of pathogens and their antimicrobial resistance profiles across different Wagner grades in patients with type 2 diabetic foot infection (DFI) ,so as to provide a basis for precise clinical anti-infective therapy.Methods Clinical data from 101 patients with type 2 DFI admitted to the First Affiliated Hospital of University of Science and Technology of China between June 2021 and May 2022 were retrospectively analyzed.Patients were divided into mild-to-moderate Grade2 and severe Grade3 and above groups based on Wagner classification.Pathogens isolated from these patients underwent species identification and antimicrobial susceptibility testing.Results A total of 137 pathogenic strains were isolated.Gram-positive (G+) bacteria accounted for 69 strains 50.4%,predominantly Staphylococcus aureus 27strains,Enterococcus faecalis 14 strains,and Staphylococcus epidermidis 7strains.Gram-negative (G-) bacteria accounted for 68 strains 49.6%,predominantly Escherichia coli 9strains,Klebsiella pneumoniae 8strains,Pseudomonas aeruginosa 7strains,and Morganella morganii 7strains.In the mild-to-moderate group,G+ bacteria accounted for 61.9%,while in the severe group,G+ bacteria occupied 45.3%.As the Wagner grade increased,the proportion of G+ bacteria decreased and the proportion of G- bacteria increased.The detection rate of multidrug-resistant organisms MDROs also increased.G+ bacteria exhibited 100% susceptibility to vancomycin,teicoplanin,and linezolid.G- bacteria exhibited 100% susceptibility to cefoperazone/sulbactam and piperacillin/tazobactam.Conclusions This study revealed that the distribution of pathogens and their antimicrobial resistance in DFI patients are closely associated with the severity of infection.As the Wagner grade increases,the proportion of G- bacteria and the risk of MDRO infection significantly increase. |
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