糖尿病合并尿路感染患者尿液细菌培养及药物敏感试验分析

Analysis of the Bacteria Culture and Microbial Sensitivity Test for Urine of Diabetes Mellitus Patients with Urinary Tract Infection

目的分析糖尿病(diabetes mellitus,DM)患者尿液细菌培养和药物敏感试验结果,为临床合理使用抗菌药物提供依据。方法取我院2013年1月—2014年12月门诊及住院1486例DM患者的尿液样本,对其细菌培养及药物敏感试验情况进行回顾性分析。结果1486例DM合并尿路感染患者尿液细菌培养阳性率9.6%(142/1486),其中检出大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌、屎肠球菌和铜绿假单胞菌总构成比为85.2%(121/142),其他菌株构成比为14.8%(21/142);药物敏感试验显示:对大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌、屎肠球菌和铜绿假单胞菌敏感性最高的抗菌药物分别为亚胺培南(85.5%)、亚胺培南(84.0%)、哌拉西林钠-他唑巴坦钠(93.8%)、万古霉素(100.0%)和头孢哌酮钠-舒巴坦(87.5%)。结论大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌、屎肠球菌、铜绿假单胞菌是导致DM合并尿路感染患者的常见致病菌;万古霉素、亚胺培南、哌拉西林钠-他唑巴坦钠和头孢哌酮钠-舒巴坦可作为DM合并尿路感染患者治疗的敏感药物。

Objective To analyze the results of bacteria culture and microbial sensitivity test of urine of diabetes mellitus（ DM） patients with urinary tract infection in order to provide basis for the rational use of antimicrobial drugs.Methods The results of bacteria culture and microbial sensitivity test of the urine samples from 1486 DM inpatients during January 2013 and December 2014 were retrospectively analyzed. Results The positive rate of bacterial culture was9. 6%（ 142 /1486） for the 1486 DM patients with urinary tract infections,in which the total constituent ratio of Escherichia coli,Klebsiella pneumoniae,Proteus mirabilis,Enterococcus faecium and Pseudomonas aeruginosa was 85. 2%（ 121 /142）,and the ration of others was 14. 8%（ 21 /142）; the microbial sensitivity test showed that the top sensitivity rate of antibacterial drugs anti-Escherichia coli,Klebsiella pneumoniae,Proteus mirabilis,Enterococcus faecium and Pseudomonas aeruginosa were Imipenem（ 85. 5%）,Imipenem 84. 0%（ 21 /25） Piperacillin-Tazobactam（ 93. 8%）,Vancomycin（ 100%） and Cefoperazone-Sulbactam（ 87. 5%） respectively. Conclusion Escherichia coli,Klebsiella pneumoniae,Proteus mirabilis,Enterococcus faecium and Pseudomonas aeruginosa are the main common pathogenic bacteria that cause urinary tract infection in DM patients,and Vancomycin,Imipenem,Piperacillin-Tazobactam and Cefoperazone-Sulbactam are antibacterial drugs in treatment of DM patients with urinary tract infection.