糖尿病患者尿路感染病原菌分布及耐药性研究

STUDY ON THE PATHOGEN DISTRIBUTION AND DRUG RESISTANCE OF DIABETES PATIENTS WITH URINARY TRACT INFECTION

目的研究糖尿病患者尿路感染病原菌分布及其耐药性,指导临床合理使用抗菌药物。方法采用临床病原学标本检测和药敏试验方法,对某医院2011-2012年住院糖尿病合并尿路感染患者尿标本进行了监测与分析。结果糖尿病合并尿路感染患者尿标本检出的病原菌中,革兰阴性杆菌占75.42%,革兰阳性球菌占15.25%。革兰阴性杆菌中大肠埃希菌、克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌分居前4位,革兰阳性菌中主要是肠球菌,还检出部分真菌。药敏试验结果显示,革兰阴性杆菌对亚胺培南与哌拉西林/他唑巴坦等抗菌药物较敏感,肠球菌对替考拉宁、利奈唑胺和万古霉素全部敏感,但对氨苄西林、红霉素、克林霉素、利福平、青霉素等耐药率较高。结论糖尿病患者尿路感染以革兰阴性杆菌为主,只对少数抗菌药物敏感,应加强监测和药敏试验,合理使用抗菌药物。

Objective To study the pathogen distribution and drug resistance of diabetes patients with urinary tract infection,and to direct proper use of antibacterial drugs.Methods The clinical etiology specimens and susceptibility examination were used to analyze the urine specimen from diabetes patients with urinary tract infection in hospital during year 2011-2012.Results Among the detected pathogens,the Gram negative bacilli accounted for 75.42% and the Gram positive cocci accounted for 15.25%.Escherichia coli,Klebsiella,Pseudomonas aeruginosa and Acinetobacter baumannii were the top four among the Gram negative bacteria,the Gram positive bacteria were mainly Enterococci and the fungi were also detected.The results of drug susceptibility tests showed that Gram negative bacteria were more sensitive to antimicrobial agents such as Imipenem and Piperacillin / Tazobactam,Enterococci was sensitive to Teicoplanin,Linezolid and Vancomycin,but had high resistance rates for Ampicillin,Erythromycin,Clindamycin,Rifampicin and Penicillin.Conclusion The urinary tract infection of diabetes patients is mainly caused by Gram negative bacilli,which is susceptible for only a few antibacterial agents.The susceptibility test should be focused for proper use of drugs.