论文部分内容阅读
目的探讨依替米星联合左氧氟沙星对糖尿病足耐甲氧西林金黄色葡萄球菌(MRSA)感染的治疗作用,并对MRSA荚膜多糖致病基因多态性进行初步研究。方法选取2012年10月—2014年10月期间于杭州师范大学附属医院接受治疗的糖尿病足MRSA感染患者78例,采用随机数字表法分为对照组和实验组。对照组39例,其中男性20例,女性19例,年龄30~72岁,平均年龄(47.8±18.2)岁,采用左氧氟沙星进行治疗;实验组39例,其中男性20例,女性19例,年龄28~75岁,平均年龄(49.1±19.5)岁,采用硫酸依替米星联合左氧氟沙星治疗,2组患者治疗时间均为4周,采用Wagner分级法对患者疗效进行评定,比较2组患者糖尿病足治疗有效率,并且对其致病因素荚膜多糖中致病基因进行研究。结果实验组临床总有效率显著高于对照组(P<0.05),在治疗后28 d,创面细菌金黄色葡萄球菌阳性率实验组显著低于对照组(P<0.05);荚膜多糖主要是通过保护细菌倍吞噬系统吞噬从而抵抗抗生素杀伤力,对患者创面细菌进行荚膜多糖基因PCR分析结果显示荚膜多糖致病基因主要以5型以及8型为主(61.5%)。结论依替米星联合左氧氟沙星对MRSA所致糖尿病足患者有较强的治疗作用,显著增加患者治疗有效率,其荚膜多糖基因主要是以荚膜多糖5型以及荚膜多糖8型为主。
Objective To investigate the therapeutic effect of etimicin combined with levofloxacin on MRSA infection in diabetic foot and preliminary study on the polymorphisms of MRSA capsular polysaccharide. Methods Seventy-eight patients with diabetic foot MRSA infection treated at Hangzhou Normal University Hospital from October 2012 to October 2014 were randomly divided into control group and experimental group. The control group of 39 cases, including 20 males and 19 females, aged 30 to 72 years, mean age (47.8 ± 18.2) years of age, the use of levofloxacin treatment; experimental group 39 cases, 20 males and 19 females, aged 28 ~ 75 years old, mean age (49.1 ± 19.5) years old, treated with etimicin and levofloxacin, the treatment time was 4 weeks in both groups, Wagner classification was used to evaluate the efficacy of the patients, compared two groups of patients with diabetic foot treatment Efficient, and its pathogenic factor in capsular polysaccharide pathogenic genes were studied. Results The total clinical effective rate in the experimental group was significantly higher than that in the control group (P <0.05). At 28 days after the treatment, the positive rate of bacteria in the wound surface in the experimental group was significantly lower than that in the control group (P <0.05) By protecting the phagocytosis of bacterial phagocytosis system to resist antibiotic lethality, PCR analysis of capsular polysaccharide gene in patients with wound surface showed that the pathogens of capsular polysaccharide were mainly type 5 and type 8 (61.5%). Conclusion Etimicin combined with levofloxacin has a strong therapeutic effect on patients with diabetic foot caused by MRSA and significantly increases the therapeutic efficiency of patients. The capsular polysaccharide gene mainly consists of capsular polysaccharide type 5 and capsular polysaccharide type 8.