糖尿病患者高龄妊娠期生殖道感染的病原体分析

Distribution of pathogens causing genital tract infections in patients with gestational diabetes at advanced age

目的探讨高龄妊娠期糖尿病患者生殖道感染的病原体分布及耐药性,为其临床防治提供依据和指导。方法选取2013年5月-2014年5月收治的76例发生生殖道感染的高龄妊娠期糖尿病患者,采集患者的分泌物标本进行病原体分离鉴定及药敏试验,对其生殖道病原体分布以及耐药性进行统计分析;采用世界卫生组织提供的WHONET5.5软件进行数据处理,并用SPSS16.0统计软件进行统计分析。结果感染部位以阴道感染为主,占54.20%,其次为宫颈、外阴和附件,分别占18.32%、14.50%和12.98%;76例患者共分离出病原体131株,以阴道假丝酵母菌为主,74株占56.49%,其次为金黄色葡萄球菌,20株占15.27%;金黄色葡萄球菌对头孢唑林的耐药率最高,为55.00%,对红霉素耐药率最低,为10.00%;阴道假丝酵母菌对咪康唑耐药率最高,为62.16%,对克霉唑耐药性最低,为7.76%。结论高龄妊娠期糖尿病患者生殖道感染检出病原体以假丝酵母菌属为主,耐药性严重,临床应根据药敏结果合理选用抗菌药物,以改善母婴结局。

OBJECTIVE To explore the distribution and drug resistance of the pathogens causing genital tract infections in the patients with gestational diabetes at advanced age so as to provide guidance for clinical prevention and treatment.METHODS A total of 76 gestational diabetes patients complicated with genital tract infections at advanced age who were treated in the hospital from May 2013 to May 2014 were enrolled in the study,then the secretion specimens were collected for the isolation and identification of pathogens,the drug susceptibility testing was carried out,the distribution and drug resistance of the pathogens causing genital tract infections were statistically analyzed,the data were processed by using WHONET5.5software offered by the WHO,and the statistical analysis was performed with the use of SPSS 16.0software.RESULTS Of the patients with genital tract infections,54.20% had the vaginal infections,18.32% had the cervical infections,14.50% had the vulvar infections,and12.98% had the accessories infections.Totally 131 strains of pathogens were isolated from the 76 patients,of which 56.49%（74strains）were vaginal Candida and 15.27%（20strains）were Staphylococcus aureus.The drug resistance rate of the S.aureus strains to cefazolin was the highest（55.00%）,and the drug resistance rate to erythromycin was the lowest（10.00%）.The drug resistance rate of the vaginal Candidato miconazole was the highest（62.16%）,and the drug resistance rate to clotrimazole was the lowest（7.76%）.CONCLUSIONThe Candida sppis dominant among the pathogens isolated from the diabetes patients complicated with genital tract infections at advanced gestational age and is highly resistant to antibiotics.It is necessary to reasonably use antibiotics based on the results of the drug susceptibility testing so as to improve the maternal and child outcomes.