糖尿病伴肺部感染临床及病原菌分析

Clinical and Pathogen Features of Pulmonary Infections in Patients with Diabetes Mellitus

目的:了解2型糖尿病伴肺部感染的临床相关因素,病原菌类型及耐药性,以指导临床合理用药。方法:选择近3年住院的糖尿病伴肺部感染患者211例,对临床相关因素(年龄、病程、症状等)、培养出的124株病原菌及药敏试验结果进行回顾性分析。结果:糖尿病伴肺部感染的发生与年龄、病程有密切关系(P<0.05),感染前5位病原菌为肺炎克雷伯杆菌29株(23.4%),铜绿假单胞菌23株(18.5%),大肠埃希菌21株(16.9%),金黄色葡萄球菌17株(13.7%),白色假丝酵母菌12株(9.7%);对分离的革兰阴性菌较敏感的前5位抗菌药物为亚胺培南、头孢哌酮舒巴坦、头孢他啶、阿米卡星、左氧氧沙星。对革兰阳性菌敏感的前3位抗生素为万古霉素,利福平,米诺环素。抗真菌药物敏感的是伊曲康唑及氟康唑。结论:年龄和病程与伴肺部感染密切相关,痰培养及药敏结果对临床治疗有较高的指导价值。

Objective：To study the clinical related factors,the distribution and drug-resistance of the pathogen in 2 type diabetic with pulmonary infection,and the supervision for rational use of drugs in clinical practice.Methods：211 in-patients were chosen in recent three years, which were accompanied with diabetes mellilus and pulmonary infection.A retrospective investigation including the related factorstage,curse of disease,symptom） and 124 cases cultivated pathogen was perfurmed.K-B method was used to test the drug- resistant strain and do drug-Sensitivity test.Results： The incidence of diabetes mcllitus complicated by pulmonary infection related closely patients, age and curse of disease （P〈0.051.The foriner five bacteria in diabetic with Pulmonary infection were klebsiella pneumoma（23.4%）,pseudomonas aeruginose（18.5%）,escherichia colt（16.9%）,staphylocccocus aureus rosenbach （13.7）and candida albicans （9.7%）.The former five sensifve antibiotics were imipcnem,sulpcrazon,ceftazidimc amikacin,levofloxacin.The former tbree antibiotics which were sensitive to G＋ cocci.were vancomycin,Rifampicin,minoeyclinc. The sensitive antifimgal were ltraconazolc and Fluconazole. Conclusion： The result of sputum cultivation and drug sensitivity wre useful to clinic.lt was important to choose antibiotic under the direction of it.