Retrospective Analysis Of Characteristics And Drug Sensitivity Of Infectious Pathogens In Patients With Different Types Of TCM Syndromes

ObjectiveThrough retrospective analyses the distribution characteristics of pathogenie bacteria and drugs sensitive test of the different TCM syndrome types of patients with diabetic foot infection in our hospital,it provides a basis for the selection of sensitive antibiotics for the prevenetion and treatment of diabetic foot infection.MethodsA retrospective study was conducted to select 151 patients with diabetic foot infection who met the inclusion criteria in the endocrinology department of Foshan Chinese Medicine Hospital from January 2015 to December 2017,and standardized TCM classification according to the Diagnostic Criteria for Diabetic foot TCM Syndrome,divided into four syndromes of yin deficiency poison,blood stasis,qi blood deficiency,yang cold bood stasis.Due to limited clinical conditions,the number of cases of qi and blood deficiency and Yang cold blood stasis i5 small,so this study combined them into other syndromes for statistical analysis.Including sex,age,length of hospital stay,duration of diabetes,duration of diabetic foot,Wagner classification,glycosylated hemoglobin,WBC count,hemoglobin,serum albumin and other related indicators and pathogenic data for analysis.Results1.The frequency of all types of syndromes in DFI patients from high to low is:yin deficiency poison,blood stasis,other syndromes.2.The relationship between DFI of different TCM syndromes and related indicators:in WBC level,there was a significant increase in Yin deficiency toxin sheng syndrome and blood stasis syndrome(P<0.01),while there was no significant difference between Yin deficiency toxin sheng syndrome and other syndromes(P>0.05).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).In the Hb level,there was a significant decrease in Yin deficiency toxin sheng and blood stasis syndrome(P<0.05),and there was no significant difference between Yin deficiency toxin sheng and other syndromes(P>0.05).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).In the HbAlc level,there was no significant difference between Yin deficiency toxin sheng and blood stasis syndrome(P>0.05),and there was a significant increase between Yin deficiency toxin sheng and other syndromes(P<0.05).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).In the ALB level,there was no significant difference between the three groups(P>0.05).At TC level,there was a significant increase in Yin deficiency toxin sheng and blood stasis syndrome(P<0.05),while there was no significant difference between Yin deficiency toxin sheng and other syndromes(P>0.05).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).In the TG level,there was a significant increase in Yin deficiency toxin sheng compared with blood stasis syndrome(P<0.05),and there was a significant increase in Yin deficiency toxin sheng compared with other syndromes(P<0.01).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).In hdl-c level,there was no significant difference between Yin deficiency toxin sheng and blood stasis syndrome(P>0.05),and Yin deficiency toxin sheng was significantly reduced compared with other syndromes(P<0.01).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).In the level of ldl-c,there was a significant increase in the excess of Yin deficiency toxin(P<0.05)compared with the excess of blood stasis syndrome(P<0.05),and a significant increase in the excess of Yin deficiency toxin(P<0.05)compared with other syndromes(P<0.05).There was no significant difference between blood stasis syndrome and other syndromes(P>0.05).3.Distribution and drug sensitive analysis of pathogens in DFI patients.192 strains of pathogens were isolated from the cultured ulcer secretions,Gram-negative bacteria account for 24%,mainly Pseudomonas aeruginosa,Klebsiella pneumoniae,Proteus vulgaris,Proteus mirabilis,Mormonella morganii and Escherichia coli infection are predominantly sensitive to most of the tested antibiotics,including sensitivity to meropenem,tobramycin,imipenem,amikacin,and ceftazidime.The rate reached 97.96%,96.55%,95.60%,92.16%,and 91.49%.The resistance rate to ampicillin is high(85.07%).Grampositive bacteria account for 44.27%,mainly Staphylovoccus aureus(incluing MRSA),Enterococcus faecalis,Streptococcus agalactiae infection,and have good sensitivity to most of the tested antibiotics.The sensitive rates to meropenem,tobramycin,imipenem,amikacin,and ceftazidime were 97.96%,95.55%,92.16%,and 91.49%,and 91.49%.The resistance rate to ampicillin is high(85.07%).There are 3 strains(1.56%)of fungi,mainly Candida tropicalis,ascomycetes,and amphotericin,fluconazole,itraconazole,flucytosine,ketoconazole,and nystatin.The sensitivity was 100%,and no strains resistant to fungal drugs were detected.4.Distribution and drug sensitivity of pathogenic bacteria with different TCM syndromes.Among the cultured pathogens,96 strains(50.00%)had Yin deficiency syndrome.There were 35 strains of blood stasis syndrome(18.23%).There were 61 strains of other syndromes(31.77%).Among the gram-negative bacteria with Yin deficiency syndrome,klebsiella pneumoniae,pseudomonas aeruginosa,escherichia coli and coumon proteobacteria were more common,and imipenem,meropenem,cefepime,ceftazidime and cefoperazone were highly sensitive to them.Gram-posi tive bacteria were mainly staphylococcus aureus,streptococcus agalactiae and enterococcus faecalis.The fungi were Candida tropicalis and ascomycosis siphiformis,but no antifungal resistance was found.Among the blood stasis syndrome,pseudomonas aeruginosa,common proteobacter,and proteobacter odoriformis were the most common gram-negative bacteria,and ceftazidime,cefoperazone,cefexidine,imipenem,meropenem,gentamicin,and amikacin were highly sensitive to them.Gram-positive bacteria were mostly staphylococcus aureus,and vancomycin,gentamicin and linezolid were highly sensitive to them.To detect fungal infection.Among the other syndromes,pseudomonas aeruginosa,klebsiella pneumoniae,proteus mirabilis,morganella moschnii and enterobacter cloacae were the most common gram-negative bacteria,and imipenem,meropenem,cefepime,ceftazidime and cefoperazone were the most sensitive.Gram-positive bacteria were mainly staphylococcus aureus and enterococcus faecalis.No fungal infection was detected.Conclusion1.The distribution of TCM syndromes in DFI patients who stay in the endocrinology of Foshan Chinese Medicine Hospital endocrinology is more common with yin poison deficiency,and the yang cold blood stasis syndrome is the smallest occurrence2.Infection of diabetic foot patients with different TCM syndrome types of the relevant laboratory analysis results show that the Yin poison of the lipid levels higher than other syndromes,and low hemoglobin and serum albumin,but from the point of the mean and standard deviation,it is concluded that by TCM syndrome types cannot deduce the statistical correlation experiment index is higher than the critical value,or in the normal range or lower than the normal range,no clinical value.Similarly,relevant laboratory indexes have no practical clinical significance in judging TCM syndrome types.3.The pathogens isolate from the wound healing of DFI in our hospital are mainly Gram-negative bacteria,followed by Gram-positive bacteria and fungal.In Gram-negative bacteria,pseudomonas aeruginosa,klebsiella pneumoniae,proteus vulgaris,proteus mirabilis,morganella morgani,Escherichia coli infection,meropenem,tobramycin,imipenem,amikacin,ceftazidime have high sensitivity,and the ampicillin is high resistance;In Gram-positive bacteria,staphylococcus aureus(including MRSA),enterococcus faecal1s,streptococcus aglalactiae,ampicillin,cefotaxime,vancomycin,linezolid,rifampicin,chloramphenicol have high sensitivity,and the penicillin has high resistance.4.Gram-negative bacteria(klebsiella pneumoniae and staphylococcus aureus)were most distributed in TCM syndromes of Yin deficiency and toxin sheng syndrome.Grarrrnegative bacteria(pseudomonas aeruginosa,staphylococcus aureus)were the most common in blood stasis syndrome.Grarrrpositive bacteria(staphylococcus aureus,enterococcus faecalis,pseudomonas aeruginosa)were the most widely distributed in other syndromes.5.In clinical practice,it is necessary to conduct pathogenic bacteria culture and drug sensitivity analysis of diabetic foot infection wound as early as possible,select sensitive antibiotic treatment,and promote wound healing.Before the results of pathogenic bacteria and drug susceptibility test are reported,according to the classification of traditional Chinese medicine and the side effects of antimicrobial drugs,it is recommended to select antibiotics sensitive to gram-negative bacteria and staphylococcus aureus,with the third and fourth generation cephalosporins,carbapenem,piperacillin,ciprofloxacin and vancomycin as the main antibiotics.