糖尿病患者尿路感染病原菌的耐药性探讨

Antimicrobial resistance of pathogenic bacteria causing urinary tract infections in diabetics patients

目的探讨医院糖尿病(DM)患者尿路感染病原菌的种类分布及耐药性,为临床医师治疗尿路感染选择抗菌药物提供试验依据。方法对医院199株糖尿病合并尿路感染患者的病原菌进行鉴定和药敏试验,细菌培养鉴定严格按照《全国临床检验操作规程》进行;药敏试验采用CLSI指定的K-B法进行操作和数据评价。结果共分离出199株病原菌,其中大肠埃希菌122株占61.3%;肺炎克雷伯菌31株占15.6%;粪肠球菌18株占9.0%;凝固酶阴性葡萄球菌12株占6.0%;检出病原菌除革兰阴性杆菌对碳青霉烯类抗菌药物、革兰阳性球菌对糖肽类抗菌药物100.0%敏感以外,对其他临床常用抗菌药物均产生了较强的耐药性。结论糖尿病患者尿路感染病原菌已表现出很强的耐药性,应以预防为主,避免因严重感染而影响患者的生存质量。

OBJECTIVE To investigate the distribution of species of pathogens causing urinary tract infections in diabetic mellitus （DM） patients and analyze the drug resistance so as to provide experimental basis for use of antibiotics in the treatment of urinary tract infections. METHODS A total of 199 strains of pathogens isolated from the DM patients complicated with urinary tract infections were identified, and the drug susceptibility testing was performed; the bacterial culture and identification were carried out in strict accordance with the National Clinical Laboratory Procedures; the drug susceptibility testing was performed and the data were evaluated by using CLSI specified K-B method. RESULTS Of totally 199 strains of pathogens isolated, there were 122 （61.3%） strains of Escherichia coli, 31 （15.6%） strains of Klebsiella pneumoniae, 18 （9.0%） strains of Enterococcus faecalis ,and 12 （6.0%） strains of coagulase-negative Staphylococci. The result of the drug susceptibility testing indicated that except for the gram-negative bacilli 100% sensitive to carbapenems and the gram-positive cocci 100% sensitive to glycopeptides, the isolated pathogens have produced high resistance to all the commonly used antibiotics. CONCLUSION The pathogens causing urinary tract infections in the DM patients are highly resistant, it is necessary to focus on the prevention so as to prevent the life quality of the patients from being affected by the severe infections.