| 陈宗存,符沙沙,陈金逸,等.糖尿病足合并类鼻疽伯克霍尔德菌感染 64例临床特征、药敏特点和治疗分析[J].安徽医药,2024,28(2):256-259. |
| 糖尿病足合并类鼻疽伯克霍尔德菌感染 64例临床特征、药敏特点和治疗分析 |
| Clinical characteristics, drug sensitivity and treatment analysis of 64 patients with diabetic foot complicated with burkholderia melioidosis infection |
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| DOI：10.3969/j.issn.1009-6469.2024.02.010 |
| 中文关键词: 糖尿病足 类鼻疽伯克霍尔德菌 药物敏感性 病原菌 |
| 英文关键词: Diabetic foot Burkholderia pseudomallei Drug sensitivity Pathogenic bacteria |
| 基金项目:海南省自然科学基金面上项目( 821MS138)；海南省重点研发计划( ZDYF2021SHFZ080)；海南省卫生计生行业科研项目( 21A200041) |
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| 中文摘要: |
| 目的总结糖尿病足( DF)合并类鼻疽伯克霍尔德菌( BP)感染的临床特征、药敏特点和治疗方法。方法回顾分析 2012年 1月至 2022年 3月海南医学院第二附属医院收治的 64例 DF合并 BP感染病人的临床表现、微生物抗菌药物敏感性及治疗手段。结果 64例 DF合并 BP感染病人中， 60例有发热症状、 34例有白细胞升高、均有 C反应蛋白( CRP)和降钙素原( PCT)升高、 14例合并肝或脾脓肿、 30例出现肝功能不全、 20例出现肾功能不全、 18例合并感染性休克。 64株 BP对大多数常见的抗生素敏感性较差，但均对亚胺培南、美罗培南和复方磺胺甲 ..唑敏感。所有病人均使用胰岛素积极控制血糖，大多数静脉应用碳青霉素烯类抗菌素约 6周，出院后继续使用复方磺胺甲 ..唑治疗。最终 22例治愈， 30例好转， 8例未愈， 4例死亡。死亡病例均合并多器官功能障碍。结论 DF合并 BP主要表现为发热、 CRP和 PCT明显升高、合并肝或脾脓肿和肝肾功能不全，易出现感染性休克。对高度怀疑 BP感染病人应多次进行培养，并及早静脉应用碳青霉素烯类抗菌素可能有助于改善预后。 |
| 英文摘要: |
| Objective To summarize the clinical characteristics, drug sensitivity and treatment of patients with diabetic foot (DF)complicated with burkholderia pseudomallei (BP) infection.Methods 64 patients with DF complicated with BP infection were retro.spectively analyzed in terms of clinical manifestations, antimicrobial sensitivity and treatment in the Second Affiliated Hospital of Hain.an Medical University from January 2012 to March 2022.Results Among the 64 patients with DF combined with BP infection, 60 had fever, 34 had leukocyte elevation, all had c-reactive protein (CRP) and procalcitonin (PCT) elevation, 14 had liver and spleen abscess,30 had liver insufficiency, 20 had renal insufficiency, and 18 had septic shock.Sixty-four strains of BP showed poor sensitivity to mostcommon antibiotics, but all were sensitive to imipenem, meropenem and cotrimoxazole. All patients were treated with insulin for glyce.mic control, and most were treated with intravenous carbapillicene antibiotics for approximately 6 weeks. Cotrimoxazole was continuedafter discharge. Finally, 22 cases were cured, 30 cases improved, 8 cases were not cured and 4 cases died. All the deaths were compli.cated with multiple organ dysfunction. Conclusions DF combined with BP mainly showed fever, significantly increased CRP andPCT, combined with liver and spleen abscess and liver and kidney dysfunction, and prone to septic shock. In patients with highly sus.pected BP infection, repeated cultures and early intravenous administration of carbopenicillene antibiotics may help improve prognosis. |
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