| Objective: to collect and sort out the clinical data of patients with type 2 diabetes mellitus and diabetic foot in our hospital in recent two years,analyze the characteristics of pathogens on the wound surface of patients with type 2 diabetes foot,and explore the relationship between the distribution of pathogens and the characteristics of drug sensitivity and the syndrome type of traditional Chinese medicine.Before the results of pathogen culture and drug sensitivity test come out,it can provide reference for the empirical use of antibiotics,and improve the sense of foot for type 2 diabetes mellitus At the same time,it can reduce the antibiotic resistance.Methods: a total of 98 patients with type 2 diabetic foot ulcer were selected from the Affiliated Hospital of Chengdu University of traditional Chinese medicine from July 2017 to October 2019.The etiological data and four diagnostic information were collected.First of all,analyze and sort out the pathogen types and drug sensitivity test results of patients,then according to the relevant guidelines of diabetic foot TCM syndrome type,according to the clinical data of 98 patients who meet the inclusion criteria,carry out unified syndrome differentiation and classification,sort out the types and drug sensitivity of pathogenic bacteria under different TCM syndrome types,and analyze their distribution laws.Results: 1.Distribution and drug sensitivity of pathogenic bacteria: 98 patients were included,70 of them were positive,the remaining 28 patients were negative,a total of 75 strains of pathogenic bacteria were cultured.Among them,there are 40 Gram-negative bacteria,30 Gram-positive bacteria and 5 fungi.The Gram-positive bacteria were Staphylococcus aureus,Enterococcus faecalis epidermidis,methicillin-resistant Staphylococcus,haemolytic Staphylococcus and Streptococcus lactis in order of quantity.The lowest resistance rate of vancomycin was only 6.66%,followed by gentamicin and levofloxacin 26.00%,then moxifloxacin 30.00%,ciprofloxacin,linezolidine and benzene The drug resistance rate of oxacillin and tetracycline was 36.66%,to clindamycin,rifampicin and compound neoforman was 40%,to erythromycin and penicillin G was 60% and 70%,respectively.According to the number of Gram-negative bacteria,they are Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,cloacae,Proteus mirabilis and colorless Bacillus xylose oxidans.There is no resistance to imipenem and ertapenem.The sensitivity distribution to levofloxacin and cefepime is 20.50% and 22.50%,and to amoxicillin,coryne and aminopyrime The drug resistance rate of Qunan was 25.00%,The drug resistance rates to piperacillin / tazobactam,Cefoperazone / sulbactam,ceftriaxone,gentamycin,tobramycin,ciprofloxacin and compound neoforman were 7.50%,37.5%,40.00%,42.50%,60.00%,62.50%,67.50% and 70.00%,respectively.The fungi were Candida albicans,actinomyces Candida is sensitive to the antifungal drugs currently used.2.TCM Syndrome Type: in 98 cases with positive pathogenic bacteria culture,there are 30 cases with Yin injury caused by heat toxin and vein stasis syndrome,among which 26 cases have positive pathogenic bacteria culture results;24 cases with damp heat toxin accumulation,rotten tendons and rotten flesh syndrome,21 cases have positive pathogenic bacteria culture results;15 cases with deficiency of Qi and blood and stasis of collaterals,6 cases with positive culture results;deficiency of liver and kidney yang,There were 16 cases of blood stasis syndrome,8 of them were positive in culture,13 of them were liver and kidney yin deficiency,8 of them were positive in culture.3.Distribution of pathogenic bacteria in different syndrome types: heat toxin injures Yin,blood stasis and dampness heat toxin accumulation,muscle rot and rotten syndrome are mainly Staphylococcus aureus and Pseudomonas aeruginosa,Qi and blood deficiency,blood stasis and liver and kidney deficiency,blood stasis and choroid syndrome are mainly Gram-negative bacteria,liver and kidney yang deficiency,blood stasis and choroid syndrome are respectively 3 Gram-negative bacteria,positive bacteria and fungi.Conclusion: 1.The pathogenic bacteria of diabetic foot wound in our hospital are mainly Gram-negative bacteria,which is consistent with our previous research.2.The resistance rate of erythromycin and penicillin G of Gram-positive bacteria is the highest,and it is the most sensitive to vancomycin,and the resistance rate to other antibiotics is lower than 40%;the resistance rate of Gram-negative bacteria to ciprofloxacin,compound xinuoming,cefazolin,ampicillin and other antibiotics is more than 60%,and the resistance rate to carbapenem antibiotics is lower than 42.50%.3.TCM syndrome type and pathogenic bacteria distribution: heat toxin injures Yin,blood stasis syndrome and dampness heat toxin accumulation,muscle rot syndrome are mainly Pseudomonas aeruginosa and Staphylococcus aureus;Qi and blood deficiency,blood stasis syndrome and liver kidney yin deficiency,blood stasis syndrome are mostly gramnegative rod bacteria;liver and kidney yang deficiency,blood stasis syndrome Gram-negative bacteria,positive bacteria and fungi are evenly distributed.4.In clinic,we can combine the distribution of pathogenic bacteria of TCM syndrome type with the results of bacterial smear examination,which can improve the accuracy of antibiotic use.5.The pathogens with thick pus wound are more sensitive to antibiotics. |
