老年糖尿病患者尿路感染的优势病原菌及药敏分析

Pathogenic Bacterial Species and Susceptibility Test in Old Age Diabetics Associated With Urinary Tract Infections

目的了解老年糖尿病患者尿路感染的优势病原菌及药敏情况。方法老年糖尿病患者尿标本按全国临床检验操作规程进行细菌有氧培养,采用Microscan细菌鉴定药敏系统仪鉴定细菌,药敏试验用微量肉汤稀释法。ESBLs检测用双纸片协同试验和表型确认方法。结果老年糖尿病患者泌尿感染的病原菌以革兰阴性杆菌为主,占61.36%,并且以大肠埃希菌为最多(占43.18%),病原菌中革兰阳性球菌以凝固酶阴性葡萄球菌和肠球菌为主,药物敏感率较好有亚胺培南、阿莫西林/棒酸、氧哌嗪青霉素、头孢唑肟、阿米卡星、较差有磺胺和喹诺酮类,并且对病原菌中大肠埃希菌和肺炎克雷伯杆菌进行ESBLs试验,大肠杆菌产ESBLs的阳性株占38.59%,还有3.79%真菌感染。结论对老年糖尿病患者尿路感染应做细菌培养和药敏试验,以指导临床正确用药,防止耐药菌株产生与发展。

Objective To investigate changes of pathogenic bacteria and drug sensitiveness in old age diabetics associated with urinary tract infections. Methods Urine samples of old age diabetics were performed bacterial culture and susceptibility test and identified by Microscan bacteria identification drug sensitive system. Results The dominant pathogenic bacteria of urinary tract infections of old age diabetics were Gram negative bacilli, which accounted for 61.36 % ; moreover, Escherichia coil was the most common pathogen and accounted for 43.18 % ; Coagulase - negative staphylococcus and Enterococcus were the most prevalent among the Gram- positive cocci. The drug susceptibility tests revealed that they were more sensitive to imipenem, amoxicillin, piperacillin, ceftizoxime and amikacin, but less sensitive to sulfanilamide and quinoiones. Meanwhile, we performed ESBLs assay in Escherichia coil and Klebsiella pneumoniae, and found that the positive ESBLs producing E. coil accounted 38.59%. Furthermore, fungi infections accounted 3.79%. Conclusion Routine urinary bacterial culture and susceptibility test in old age diabetics with urinary tract infections that direct the rational clinic medication and preventing development of drug resistant strains should be emphasized.