84例糖尿病伴大肠埃希菌尿路感染药敏分析

Analysis of Drug Sensitivity Test of Escherichia Coli in Urinary Tract Infection in 84 Patients with Diabetes Mellitus

目的回顾性分析糖尿病伴大肠埃希菌尿路感染病例药敏试验结果,以指导临床合理选择抗生素。方法取糖尿病伴尿路感染的患者清洁中段尿进行培养,用法国梅里埃自动鉴定仪进行细菌鉴定及药敏试验;按年份、超广谱β-内酰胺酶(ESBLs)等分组分析。结果在165份尿培养阳性标本中检出大肠埃希菌占50.9%(84/165),大肠埃希菌ESBLs阳性率41.7%(35/84),ESBLs阳性菌株对多种常用抗菌素的耐药率高于ESBLs阴性菌株,所有菌株均对亚胺培南、美罗培南敏感;ESBLs阳性组有3例合并肠球菌感染,其中1例万古霉素耐药;近期组较早期组ESBLs阳性率明显升高、耐药状况更严重。结论糖尿病伴大肠埃希菌尿路感染应根据药敏试验结果合理使用抗生素,亚胺培南、美罗培南为敏感药物。

Objective To analyze the drug-resistance of Escherichia Coli in patients with diabetes mellitus and urinary tract infection, and to provide scientific evidence for rational use of antibiotics. Methods Urinary samples were collected from patients with diabetes mellitus and urinary tract infection. They were cultivated and analyzed by drug sensitivity test and ESBLs test. Results The detection rate of Escherichia Coli was 50.9% （84/165） in urinary samples,The detection rates of ESBLs was 41.7% （35/ 84） in Escherichia Coli, and the resistance rate of ESBLs （ ＋ ） Escherichia Coli was higher than that of ESBLs （ - ）. All of these strains were sensitive to imipenem and meropenem. Among the strains of ESBLs （ ＋ ） Escherichia Coli, there were three strains co-infected by Enterococcus, one of which were resistant to Vancomycin. The positive rate of ESBLs strains was higher in recent group than that in previous group, and the drug resistance was more serious. Conclusion Antibiotics should be used rationally according to drug sensitive test for patients with diabetes mellitus and urinary tract infection, and imipenem and meropenem was demonstrated to be sensitive drug to Escherichia Coli in this study.