糖尿病患者并发院内肺部感染的临床分析

Clinical Analysis on Diabetes Patients Complicated with Hospital-acquired Lung Infection

目的探讨糖尿病合并肺部感染的临床特点、危险因素、病原菌种类及耐药性分析,并进行总结分析,为降低糖尿病患者肺部感染的发生率提出预防和治疗措施。方法对2011年-2013年住院糖尿病患者发生院内肺部感染的临床资料进行回顾性分析。结果 572例住院糖尿病患者中78例并发院内肺部感染;糖尿病并发院内肺部感染的相关因素分别是年龄、糖尿病并发症、慢性基础疾病、病程、住院时间、糖化血红蛋白、侵入性操作,与非感染组相比,差异均有统计学意义(P<0.05);78例糖尿病并发肺部感染患者痰培养和咽拭子培养共检出59株病原菌,主要为多重耐药的G-杆菌,占71.2%。结论糖尿病患者合并院内肺部感染的发生率高,病原菌多为多重耐药的G-杆菌,对常用抗菌药物耐药明显,控制血糖、合理使用抗菌药物、缩短住院时间、有效预防和治疗糖尿病的并发症及慢性基础疾病、无菌操作等可有效预防糖尿病肺部感染的发生。

Objective To analyze and summarize the clinical characteristics, risk factors, pathogenic bacteria type, and drug tolerance of diabetes complicated with hospital-acquired pulmonary infection, in order to reduce the incidence of hospital-acquired pulmonary infection in patients with diabetes. Methods The clinical data of diabetic patients with hospital-acquired pulmonary infection from 2011 to 2013 were taken for retrospective clinical analysis. Results A total of 78 diabetic patients had hospital-acquired pulmonary infection among all the 572 hospitalized patients with diabetes. Age, complications of diabetes, chronic underlying disease, duration of hospital stay, glycated hemoglobin and invasive procedures were all correlated with the incidence of hospital-acquired infection（P 〈 0.05）. ThrougThsputum culture and throat culture, 59 strains of pathogens were found, and they were mainly multidrug-resistant Gram-negative bacteria, accounting for 71.2%. Conclusions The rate of acquired pulmonary infection in diabetic patients is particularly high, and the pathogens are mostly Gram-negative and multidrug-resistant. Glycemic control, rational use of antimicrobial drugs, shorter hospital stay, ef ective prevention and treatment of diabetes complications and chronic underlying diseases, and aseptic techniques can be ef ective in preventing acquired pulmonary infection for diabetic patients.