鼻腔携带金黄色葡萄球菌是糖尿病足部感染的风险因素

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糖尿病患者中的感染性足部溃疡通常与鼻腔携带金黄色葡萄球菌相关

背景

足部感染是糖尿病患者住院的重要原因，随着耐多药型微生物（如耐甲氧西林金黄色葡萄球菌 [MRSA]）不断增多，它已成为一个人们最为关心的问题。 糖尿病性足部感染的主要病原体是金葡菌 ，且人们认为，鼻腔携带金葡菌 是发生这类感染的重要风险因素。

·                           本研究调查了糖尿病患者的感染性足部溃疡中 MRSA 与鼻腔中该菌之间的相关性。

·                           本研究招募了 230名糖尿病患者，他们均出现了感染性足部溃疡，且在之前的 21 天内并未接受过抗生素治疗。 研究人员从患者的足部溃疡和鼻腔中提取了拭子，并分离了金葡菌 菌株。 研究人员运用断点稀释法测试了隔离群的抗生素敏感性谱。

·                           总体而言，71 名患者 (30.87%) 在足部溃疡和鼻腔携带测试中均呈金葡菌 阳性；其中，29 名患者 (40.85%) 所携带的金葡菌 具有甲氧西林耐药性。

·                           根据从糖尿病足部溃疡和鼻腔中所采集的 222 株金葡菌 菌株的抗生素敏感性谱，研究人员发现，利福平 (96.40%) 是最有效的抗生素，其次为左旋氧氟沙星(91.44%) 和夫西地酸 (86.49%)。

结论

“糖尿病患者的足部感染存在金葡菌 通常与鼻腔携带金葡菌 相关，反之亦然。” 利福平、左旋氧氟沙星、夫西地酸和阿米卡星可有效对抗所收集到的大部分金葡菌 菌株。

Taha AB. Relationship and susceptibility profile of Staphylococcusaureus infection diabetic foot ulcers with Staphylococcus aureus nasal carriage.Foot (Edinb). [Epub ahead of print 2012 Dec 19].

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[size=0.8465em]Foot (Edinb). 2013 Mar;23(1):11-16. doi: 10.1016/j.foot.2012.10.003. Epub 2012 Dec 21.
Relationship and susceptibility profile of Staphylococcus aureus infection diabetic foot ulcers withStaphylococcus aureus nasal carriage.[size=0.923em]Taha AB.
[size=0.8465em]Source

College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq. Electronic address: tahaaza@yahoo.com.

AbstractBACKGROUND:

Staphylococcus aureus is the main cause of diabetic foot infection with the patient's endogenous flora as the principal source. Nasalcarriage of S. aureus has been identified as an important risk factor for the acquisition of diabetic foot infections.

OBJECTIVES:

The study assessment the associations of S. aureus with methicillin resistant S. aureus were isolation from diabetic foot infection andnasal carriage of the same patients and their antibiotic susceptibility profile.

METHODS:

Diagnosis of S. aureus and methicillin resistant S. aureus were carried out by using standard procedures. Antibiotic sensitivity profiles were determent by breakpoint dilution method.

RESULTS:

Out of 222 S. aureus isolation, 139 (62.61%) were isolated from the diabetic foot and 83 (37.39%) from the nasal carriage. Seventy one (30.87%) of the patients were S. aureus infection diabetic foot with nasal carriage. Among diabetic foot infection and nasal carriage patients, 40.85% of S. aureus were considered as methicillin resistant S. aureus. Rifampicin (96.40%) and Levofloxacin (91.44%) were active against S. aureus.

CONCLUSION:

Patients at strong risk for methicillin resistant S. aureus nasal carriage and subsequent diabetic foot infection with high resistance to antibiotics.

Copyright © 2012 Elsevier Ltd. All rights reserved.