Distribution Patterns And Drug Susceptibility Analysis Of Pathogenic Bacteria From The Wound Secretion Of 136 Diabetic Foot Cases

Objective:To study the pathogenic bacteria species distribution and drug resistance in patients with diabetic foot,and to provide empirical reference for anti-infection therapy.Methods:Collect and investigate the clinical data of 136 patients with diabetic foot,recruited from January 2014 to December 2017 in Taicang First People’s Hospital,and analyze the statistical positive rate of bacteria,species distribution patterns and drug resistance in patients with diabetic foot.Results:A total of 136 specimens were collected,and 123 bacteria positive specimens were detected,with a bacteria positive rate of 90.4%,and of which 127 bacteria strains were isolated,including 60 Gram-negative bacteria strains(47.2%),67 Gram-positive bacteria strains(52.8%),and 4 mixed infection strains(3.1%)(all of which are gram-negative bacilli).Gram-positive bacteria were mainly composed of Staphylococcus aureus(39 cases),Enterococcus faecalis(5 cases)and non-Streptococcus suis(5 cases);Gram-negative bacteria mainly comprised of Escherichia coli(9 cases),intestinal bacteria(5 cases),Klebsiella pneumoniae(6 cases)and Proteus(9 cases).The isolated Gram-positive bacteria were found sensitive to vancomycin and linezolid,and their resistance rates to penicillin,clindamycin and erythromycin were all higher than 50%.The isolated Gram-negative bacteria had a high sensitivity to Piperacillin,Cefoperazone and Sulbactam,with the sensitivity rate 92.6%,92.5%,relatively.One strain Baomanli was found resistant to imipenem,and the rest were shown sensitivity to imipenem and meropenem.The positive rate of ESBL bacteria in intestinal bacilli was 44.4%.Conclusion:The bacterial positive rate in patients with diabetic foot disease was high,with a variety of bacteria species detected in wound secretion.The proportion of gram-positive bacteria and gram-negative bacteria were similar.Staphylococcus aureus was the most prevalent in Gram-positive bacteria strains,which had a high resistance rate to penicillin and erythromycin,while full sensitive to vancomycin;Escherichia coli accounted for a large proportion in Gram-negative bacteria,which had a high resistance to Ampicillin,Piperacillin and cefazolin,while sensitive to Tazobactam with enzyme,Cefoperazone and Sulbactam,and Carbapenem antibiotics such as meropenem and imipenem.Since there was a high positive rate of ESBL in Gram-negative bacteria,and a high resistance rate in general penicillin and the cephalosporin antibiotic,enzyme antibiotics such as piperacillin and carbon Penicillium antibiotics are here recommended for diabetic foot anti-bacteria therapy.