老年糖尿病患者泌尿道感染的病原谱及药敏分析

Pathogen distribution and drug resistance in elderly diabetic patients with urinary tract infection

目的了解老年糖尿病患者泌尿道感染的常见病原菌及药敏情况。方法采用细菌培养鉴定、药敏试验方法，对老年糖尿病合并泌尿道感染患者的70株中段尿分离菌株进行统计学分析。结果70株病原菌中，革兰氏阴性菌占65．7％；革兰氏阳性菌占21．4％；真菌占12．9％。革兰氏阴性菌中大肠埃希菌最多；革兰氏阳性菌中溶血葡萄球菌最多，未发现对万古霉素耐药的肠球菌。真菌以白假丝酵母菌为主。革兰氏阴性菌敏感性高的抗生素：美洛培南和亚胺培南、头孢吡肟、阿米卡星、哌拉西林／他唑巴坦；革兰氏阳性菌中，溶血葡萄球菌对夫西地酸、利福平、米诺环素、替考拉宁、万古霉素、呋喃妥因、喹奴普汀／达福普汀高度敏感，粪肠球菌及屎肠球菌仅对替考拉宁、万古霉素敏感性较高。白假丝酵母菌对氟康唑、伊曲康唑等药物敏感性较高。结论老年糖尿病患者合并泌尿道感染，常见的致病菌为革兰氏阴性菌。因细菌耐药率高，应及早进行中段尿培养及药敏试验。

Objective To investigate the pathogen distribution and drug resistance in elderly diabetic patients with urinary tract infection. Methods Seventy bacteria strains isolated from the midstream urine of elderly diabetic patients with urinary tract infection were statistically analyzed by pathogens cultivation and drug resistance. Results Among 70 bacteria strains, Gram negative bacteria accounted for 65.7%, Gram positive bacteria accounted for 21.4% and fungi accounted for 12.9%. Escherichia coli was the predominant pathogen among the Gram negative bacteria; while Staphylococcus haemolyticus was the predominant pathogen among the Gram positive bacteria. The Enterococci resistant to Vancomycin was not found. Monilia albicans was the predominant pathogen among fungi. The Gram negative bacteria were sensitive to the following antibiotics： Meropenem, Imipenem, Cefepime, Amikacin and Piperacillin/Tazobactam. Among the Gram positive bacteria, Staphylococcus haemolyticus was sensitive to the following antibiotics： Fusidic acid, Rifampicin, Minocycline, Teicoplanin, Vancomycin, Nitrofurantoin and Quinupristin/Dalfopistin; while Enterococcus faecalis and Enterococcus Faecium were just sensitive to Teicoplanin and Vancomycin. Monilia albicans was sensitive to Fluconazol and Itraconazole. Conclusion Gram negative bacteria were the predominant pathogens in elderly diabetic patients with urinary tract infection. Because of the high antibiotic resistance, it is important to perform urine bacterial culture and drug susceptibility tests in time.