老年2型糖尿病患者非发酵菌感染菌群分布与耐药性分析

Bacteria Distribution and Antibiotic Resistance of Non-fermenting Bacteria that Cause Infection in Senile Patients with Type 2 Diabetes

目的探讨引起老年2型糖尿病患者医院感染的非发酵菌分布与对常用抗菌药物的耐药情况。方法对从老年2型糖尿病患者标本分离出的123株非发酵菌进行对常用抗菌药物的敏感性及其临床感染分布作回顾性分析。结果123株非发酵菌中前4位非发酵菌依次是铜绿色假单胞菌、洋葱伯克霍尔德菌、鲍氏不动杆菌和嗜麦芽寡养单胞菌;非发酵菌分离株ESBLs、AmpC和MBL检出率分别为15.44%、13.00%和17.07%,对抗菌药物耐药率较高,呈多药耐药性,非发酵菌单产酶株、双产酶株对多数抗菌药物的耐药率明显高于非产酶株(P<0.05),单产酶株与双产酶株耐药率相近。结论非发酵菌是引起医院感染的最常见的病原菌之一,且易侵袭老年2型糖尿病患者,对抗菌药物呈多药耐药性,定期监测非发酵菌感染细菌种类、耐药性变化对指导临床合理应用抗菌药物具有十分重要的意义。

OBJECTIVE To investigate the distribution of the non-fermenting bacteria that cause infection in senile patients with type 2 diabetes and analyze their antibiotic resistance. METHODS The data of the distribution and antibiotic resistance of the 123 isolates were retrospectively analyzed. RESULTS The most four common non-fermenting bacteria were Pseudomonas aeruginosa, Burkholderia cepacia, Acinetobacter baurnannii, and Stenotrophomonas maltophilia. The detectable rate of ESBLs, AmpC and MBL was 15. 44%, 13. 00% and 17.07% in non-fermenting bacteria. At the same time, the isolated strains showed higher resistance rate and multi-drug resistance. The drug resistance rate of the enzyme-producing non-fermenting bacteria was much higher than that without enzyme （P〈 0. 05）, and it was similar to single-enzyme-producing strains, dual-enzyme production strains. CONCLUSIONS Non-fermenting bacteria are the most common pathogens causing hospital infection especially for senile patients with type 2 diabetes and show the multi-drug resistance. It＇s important to monitor the variation of bacteria species and drug resistance periodically to guide clinical antibiotics use.