糖尿病患者伴尿路感染病原菌检测及耐药性分析

Distribution and drug resistance of pathogens causing urinary tract infections in diabetes patients

目的研究糖尿病伴尿路感染患者的病原菌分布情况及耐药性特点,为临床治疗提供相关依据。方法选取2009年10月-2012年9月诊断为糖尿病伴尿路感染的242例患者,对其进行病原菌鉴定及体外药敏试验。结果糖尿病伴尿路感染患者中共分离出病原菌242株,排名前3位病原菌依次为大肠埃希菌、肠球菌属、肺炎克雷伯菌,分别占59.92%、10.33%、9.92%;大肠埃希菌中超广谱β-内酰胺酶菌株共检出51株,检出率为35.17%;肺炎克雷伯菌中共检出8株,检出率为33.33%;革兰阴性菌除对美罗培南、亚胺培南及阿米卡星敏感外,对其他抗菌药物均产生了一定的耐药性,革兰阳性菌除对万古霉素100.0%敏感外,对其他抗菌药物均产生了一定的耐药性。结论糖尿病伴尿路感染患者病原菌的耐药性较强,应注意预防及控制该疾病的发生。

OBJECTIVE To observe the distribution of pathogens in the diabetes patients complicated with urinary tract infections and analyze the characteristics of drug resistance so as to provide basis for the clinical treatment.METHODS A total of 242patients,who were diagnosed as the diabetes complicated with urinary tract infections from Oct 2009to Sep 2012,were enrolled in the study,then the bacterial identification and the in vitro drug susceptibility testing were carried out.RESULTS A total of 242strains of pathogens were isolated form the diabetes patients complicated with urinary tract infections,among which the top three species were in turn as Escherichia coli,Enterococus,and Klebsiella pneumoniae,accounting for 59.92%,10.33%,and 9.92%,respectively.There were 51（35.17%）strains of extended spectrumβ-lactamase（ESBLs）-producing E.coli and 8（33.33%）strains of ESBLs-producing K.pneumoniae.The gram-negative bacteria have produced certain drug resistance to all the antibiotics except meropenem,imipenem,and amikacin,and the gram-positive bacteria have produced certain drug resistance to all the antibiotics except 100.0% of the susceptibility rate to vancomycin.CONCLUSIONThe pathogens isolated from the diabetes patients complicated with urinary tract infections are highly drug-resistant,it is necessary to focus on the prevention and control of the disease.