糖尿病患者感染病原菌监测结果分析

Monitoring Results Analysis of Pathogens Infected in Diabetic Patients

目的了解医院糖尿病患者感染主要病原菌类型分布以及耐药性的变化,为临床医师合理使用抗感染治疗提供依据。方法总结分析医院2005年1月-2009年12月糖尿病合并感染病例病原菌培养以及药敏试验结果,了解不同时间医院感染病原菌分布与耐药性。结果在连续5年送检的2238份感染患者标本中,共分离培养出病原菌901株,革兰阴性菌占74.6%(672株),革兰阳性菌占5.5%(50株),假丝酵母菌属占19.9%(179株);其中大肠埃希菌中ESBLs检出率45.6%,肺炎克雷伯菌ESBLs检出率25.1%,革兰阳性球菌主要是葡萄球菌属(50.0%)和肠球菌属(46.0%),其中MRSA的检出率占金黄色葡萄球菌的21.7%,VRE的检出率为0。结论医院糖尿病感染的主要病原菌为革兰阴性杆菌,ESBLs及铜绿假单胞菌耐药率呈逐年上升趋势,提示临床医师高度重视抗感染的治疗。

OBJECTIVE To study the distribution and drug resistance of nosocomial infection（NI） pathogens in diabetic patients,as well as to provide a reasonable basis for clinicians to use anti-infective therapy.METHODS The NI pathogens in diabetic patients collected between Jan 2005 and Dec 2009 were completely surveyed and analyzed.RESULTS Totally 901 strains of NI pathogens were isolated from 2238 cultured samples.Among in the isolated pathogens,G^-pathogens accounted for 74.6%（672 samples）,G^＋ 5.5%（50 samples）,and Candida for 19.9%（179 samples）.The rate of ESBLs in E.coli reached 45.6%,and 25.1% in K.pneumoniae.The first two predominant G^＋ pathogens were Staphylococcus（50%,25 samples） and Enterococcus（46%,23 samples）.The rate of meticillin-resistant Staphylococcus aureus（MRSA） in S.aureus was 21.7%,and the rate of vancomycin-resistant Enterococcus（VER） in Enterococcus 0%.CONCLUSIONS The major infective pathogens in diabetic patients are G^-bacilli,ESBLs producers and Pseudomonas aeruginosa,the dug resistance rate of which is increasing year by year,suggesting that the clinicians attach great importance to the anti-infection treatment.