2型糖尿病合并泌尿系统感染常见病原菌耐药性分析与对策

Main Pathogenic Bacteria Resistance and Application of Antibacterials of Urinary System Infection in T2DM

目的了解医院内分泌科2型糖尿病(T2DM)合并泌尿系统感染的常见病原菌及其耐药性,制定出临床抗菌药物应用对策。方法采用回顾性病例分析的方法,分析医院内分泌科住院患者中T2DM合并泌尿系统感染者抗感染治疗情况,数据应用SPSS11.0软件进行处理。结果T2DM合并泌尿系统感染经验用药以氟喹诺酮类为主,但常见病原菌中大肠埃希菌和表皮葡萄球菌对左氧氟沙星和环丙沙星的耐药率分别为18.2%、63.6%和16.7%、50.0%;有无细菌培养及药敏的患者抗菌药物治疗时间分别为(8.4±4.3)d和(10.4±5.4)d(P<0.05)。结论T2DM合并泌尿系统感染可选用β-内酰胺类+β-内酰胺酶抑制剂及氨基糖苷类药物进行治疗,依据细菌学培养结果选择治疗方案可显著降低治疗天数。

OBJECTIVE To investigate the variety of main pathogenic bacteria and their resistance in urinary system infection of type 2 diabetes mellitus （T2DM） in endocrinology department of our hospital and find out the best choice antibacterials of application. METHODS By retrospective analysis of clinical history, the results of urine bacterial culture, drug sensitivity reports of T2DM patients with urinary system infection were analyzed. The data were dealed with SPSS 11. 0. RESULTS The drugs of experiential therapy were mainly quinolones. And drug resistant rates of Escherichia coli and Staphylococcus epidermidis to levofloxacin and ciprofloxacin were 18.2% and 63.6%, and 16.7% and 50.0% respectively. The treatment periods of 2 groups were （8. 4±4. 3）d and （10.4 ±5.4）d, respectively. CONCLUSIONS β-Lactam/β-lactamase inhibitor and aminoglycosides are the first choice in experiential therapy. Thetreatment periods could be decreased according to bacterial culturingresuhs.