Distribution And Antibiotic Resistance Of Pathogens In58Diabetic Foot Infection

Objective:To investigate bacteria characteristic and their sensitivity to antibiotics of pathogens culture in diabetic patients with diabetic foot infection.Methods:A retrospective study was carried out on the data of58diabetic patients with diabetic foot infection. The category of bacteria in the pathogen culture, their sensitivity to different antibiotics and the other basic indicators were analized in these patients from January,2010to January,2014in the Qilu Hospital of Shandong University.Results:①52strains of pathogens were isolated from Fifty-eight inpatients with diabetic foot ulcer. No pathogenic bacteria were isolated.in9patients.②Among those pathogens,13strains (25.00%) were Gram-positive(G+) bacteria and the most common ones were Enterococcus faecalis (7.69%), Staphylococcus aureus (5.77%), Coagulase negative staphylococci (5.77%), Streptococcu (3.85%), Staphylococcus epidermidis (1.92%). The Gram-positive bacteria were more sensitive to nitrofurantoin, linezolid and teicoplanin. Thirty-seven strains (71.15%) were Gram-negative (G-) bacteria, the most strains were enterobacterium (53.85%), including Escherichia coli (19.23%),M. morganii’s subspecie (15.38%),Proteus (15.38%),Citrobacter koseri (5.77%).There were also other Gram-negative bacteria including Baumanii,Pseudomonas aeruginosa,paucimobilis (sharingl7.31%).The Gram-negative bacteria were more sensitive to Carbapenems, the forth cephalosporins oxacillin and piperacillin/tazobactam. Monilia albicans and Candida parapsilosis were also isolated and sensitive to all kinds of antifungal drugs. Three cases of the infection were mixed, including Gram-positive cocci and Gram-negative bacilli or two kinds of Gram-negative bacilli.Conclusion:①Gram-negative strains is the most common bacteria in wounds of diabetic foot infection, and the second is Gram-positive strains. Fungus is rare in those patients. Pathogenic bacteria spectrum has had the obvious change, by mainly gram-positive coccus into mainly gram-negative bacilli.②The Gram-positive bacteria were more sensitive to nitrofurantoin, linezolid and teicoplanin. The Gram-negative bacteria were more sensitive to Carbapenems, the forth cephalosporins oxacillin and piperacillin/tazobactam.③Common bacterial culture and drug sensitivity test should be conducted as early as possible so that appropriate antimicrobial agents could be chosen in order to reduce the generation of drug-resistance and promote the healing of ulcer. Before the result comes out,our suggestion is that antibiotics against gram-negative bacteria be chosen first and Carbapenems, the forth cephalosporins oxacillin and piperacillin/tazobactam are the first choices.