2型糖尿病患者泌尿系感染大肠埃希菌的耐药性分析

Drug resistance of Escherichia coli causing urinary tract infection in patients with type 2 diabetes

目的分析内分泌科2型糖尿病患者泌尿系感染大肠埃希菌的药敏率,为临床合理用药提供依据。方法回顾性分析2011年1月-2012年12月医院内分泌科389例2型糖尿病合并感染的患者临床资料,药敏试验采用美国临床实验室标准化研究所(CLSI)推荐的K-B法,采用WHONET5.4软件进行统计分析处理。结果 389例感染患者其中泌尿系感染235例占60.41%;呼吸道感染98例占24.67%;胆道感染31例占7.99%;糖尿病足感染11例占2.83%;皮肤软组织感染9例占2.31%;其他感染5例占1.29%;其中235例泌尿系感染分离的病原菌主要为大肠埃希菌,176株占74.89%;大肠埃希菌对哌拉西林/他唑巴坦、亚胺培南、美罗培南耐药率为0,对头孢哌酮/舒巴坦耐药率为1.14%、对喹诺酮耐药>80.0%、对氨苄西林耐药率>90.00%。结论 2型糖尿病合并泌尿系感染的患者大肠埃希菌病原菌均具有较高的耐药性,应加强病原菌及耐药性监测,根据药敏结果合理选用抗菌药物。

OBJECTIVE To analyze the drug susceptibility rate of Escherichia coli causing urinary tract infection in patients with type 2 diabetes in department of endocrinology so as to provide guidance for reasonable clinical use of antibiotics .METHODS The clinical data of 389 type 2 diabetes patients complicated with infections who were trea-ted in the department of endocrinology from Jan 2011 to Dec 2012 were retrospectively analyzed ,then the drug susceptibility testing was performed with the use of K-B method recommended by Clinical Laboratory Standard Institute （CLSI） ,and the statistical analysis was carried out by using WHONET5 .4 software .RESULTS Among the 389 patients with infections ,there were 235 （60 .41% ） cases of urinary tract infections ,98 （24 .67% ） cases of respiratory tract infections ,and 31 （7 .99% ） cases of biliary tract infections ,11 （2 .83% ） cases of diabetic foot ,9 （2 .31% ） cases of skin and soft tissue infections ,and 5 （1 .29% ） cases of other infections . E .coli was the predominant species of pathogen isolated from the 235 patients with urinary tract infection ,accounting for 74 .89%（176 strains） .The drug resistance rates of the E .coli to piperacillin-tazobactam ,imipenem ,and meropenem were 0% ,the drug resistance rate to cefoperazone-sulbactam was 1 .14% ,quinolones more than 80 .0% ,ampicillin more than 90 .00% .CONCLUSION E .coli isolated from the type 2 diabetes patients complicated with urinary tract infections is highly drug resistant ;it is necessary to strengthen the monitoring of pathogens and drug resistance and reasonably use antibiotics based on the result of drug susceptibility testing .