糖尿病合并下呼吸道感染203例临床分析

Clinical analysis of 203 diabetic patients with lower respiratory tract infection

目的:探讨糖尿病下呼吸道感染的细菌特点及耐药情况。方法:回顾性分析203例以下呼吸道感染症状就诊的糖尿病患者住院的临床资料。结果:社区糖尿病患者下呼吸道感染的病原菌以肺炎链球菌为主要致病菌,占45.5%,其次是革兰阴性杆菌、金黄色葡萄球菌、表皮葡萄球菌、非典型性致病菌、真菌。除肺炎链球菌外,革兰阳性球菌对万古霉素耐药率为0%,肺炎链球菌对万古霉素耐药率为5%,革兰阴性杆菌中,嗜麦芽假单胞菌对亚胺培南天然耐药,已发现大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌对亚胺培南的耐药菌株,耐药率为分别5%、5%、10%。结论:社区糖尿病下呼吸道感染病原菌以G+球菌常见,对万古霉素高度敏感。应重视社区糖尿病下呼吸道感染细菌学特点及耐药性,合理使用抗生素,积极改善脏器功能,以提高治愈率。

Objective：To analyze the bacteriological characteristics and drug resistance in diabetic patients with lower respiratory tract infection（LRTI）.Methods：To retrospectively analyse the clinical data of 203 inpatients of diabetes with respiratory infection symp-toms.Results：Streptococcus penumoniae（45.5%） was main pathogen of lower respiratory tract infection in diabetic patients,followed by gram-negative bacillus,staphylococcus aureus, staphylococcus epidermidis,atypical pathogenic bacteria, fungi.Except the streptococcus pneumoniae,gram-positive cocci resistance to vancomycin was 0%, streptococcus pneumoniae resistant to vancomyein was 5%.In gram- negative bacilli ,Pseudomonas maltophilia natural resistance to imipenem, Escheriehia coli, Pseudomonas aeruginosa, Enterobaeter cloacae strains resistant to imipenem,was 5% ,5%, 10% respectively.Conclusion：LRTI Gram-positive cocci is common pathogen of community diabetes, vaneomycin is highly sensitive. Should attach importance to the bacteriological characteristics and drug resistance of community diabetes LRTI.Reasonable use of antibiotics and actively improve visceral function can improve the curative rate.