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糖尿病足部感染中的厌氧菌:病理生理学,流行病学,毒性和管理
Fanny Villa1, Hélène Marchandin2, Jean-Philippe Lavigne3
1VBIC, INSERM U1047, Univ Montpellier, Service des Maladies Infectieuses et Tropicales, CHU Nîmes, Nîmes, France.
Clinical microbiology reviews
|May 31, 2024
概括
厌氧体在糖尿病足部感染 (DFI) 中很常见,通常被传统文化遗漏. 先进的测序揭示了它们在伤口愈合和结果中的重要作用,需要无氧向治疗.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病足部感染 (DFI) 是一个重大的全球健康挑战.
- DFI是复杂的,多微生物的,与生物膜相关的感染.
- 厌氧生物与DFI病理生理学有关,但由于检测困难,人们对它们的作用知之甚少.
研究的目的:
- 描述无氧细菌在糖尿病足部感染中的流行程度和影响.
- 为了比较DFI中无气生物的检测方法.
- 评估特定无气虫与临床结果的关联,并为治疗策略提供信息.
主要方法:
- 对利用细菌培养和16S rRNA基因测序进行DFI分析的研究进行审查.
- 针对不同检测方法的无氧流行的加权平均计算.
- 无氧体检测和临床参数 (损伤深度,持续时间,愈合,截肢) 之间的相关性分析.
主要成果:
- 培养方法在17%的DFI病例中检测到厌氧生物,而16SrRNA测序在83.8%的病例中发现了它们.
- 无气性病在较深的病变中更为普遍,并与发烧,气味和持续时间更长相关.
- 特定的厌氧生物,如*Peptoniphilus* spp.,*Fusobacterium* spp.,和*Bacteroides* spp. 这三种类型的细菌. 分别与受损愈合,长期感染和截肢风险有关.
结论:
- 在检测DFI中的无氧生物中,培养独立的方法显著优于培养.
- 无气体体对DFI的进展和患者的结果起着至关重要的作用.
- 建议在中度至重度的DFI时进行联合除菌和无氧有效的抗生素治疗.
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