老年糖尿病患者合并泌尿系感染病原菌分布及耐药性

Distribution and drug resistance of pathogens causing urinary tract infection in elderly patients with diabetes

目的探讨老年糖尿病患者合并泌尿系感染病原菌的分布及其耐药性,为临床防治提供实验依据。方法回顾性分析2011年1月至2014年12月桐乡市第三人民医院老年糖尿病患者合并泌尿系感染患者的尿液标本做病原学检测和药敏试验,并用WHONET 5.4软件对耐药数据进行统计分析。结果共分离出病原菌267株,包括革兰阴性菌173株(64.79%),前四位为大肠埃希菌、肺炎克雷伯菌、奇异变形菌和阴沟肠杆菌;革兰阳性菌52株(19.48%),前三位为肠球菌属、金黄色葡萄球菌和表皮葡萄球菌;真菌42株(15.73%)。药敏结果显示,主要革兰阴性菌对阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和亚胺培南耐药率较低,主要革兰阳性菌对利福平、呋喃妥因、利奈唑胺、替考拉宁和万古霉素耐药率较低。结论老年糖尿病患者易发生泌尿系感染临床应结合药敏试验合理使用抗菌药物,减少耐药株的产生。

Objective To explore the distribution and drug resistance of pathogens from aged diabetic patients with urinary tract infection,so as to provide evidence for clinical prevention and treatment.Methods Urine specimens of aged diabetic patients with urinary infection from Jan.2011 to Dec.2014 were collected.Then the pathogens were detected and drug sensitivity tests were conducted.WHONET 5.4software was used for statistical analysis.Results A total of 267 strains of bacteria were isolated,including 173 strains of gram-negative bacteria（64.79%）,the top four of which were Escherichia coli,Klebsiella pneumoniae,Proteus mirabilis and Enterobacter cloacae.There were 52 strains of Gram-positive bacteria（19.48%）,the top three of which were Enterococcus,Staphylococcus aureus and Staphylococcus epidermidis.42 strains of fungi were isolated（15.73%）.The main gram-negative bacteria exhibited low drug resistance rates to Amikacin,Piperacillin/tazobactam,Cefoperazone/sulbactam and Imipenem,while the main gram-positive bacteria showed low drug resistance rates to Rifampicin,Nitrofurantoin,Linezolid,Tigecycline and Vancomycin.Conclusion Aged diabetic patients are prone to suffer from urinary tract infection;antibiotics should be used reasonably to prevent the development of drug resistant strains.