糖尿病并发尿路感染患者病原菌分布与危险因素分析

Distribution and influencing factors of pathogenic bacteria in diabetic patients with urinary tract infection

目的研究糖尿病并发尿路感染患者病原菌分布情况及其影响因素,为此类患者的治疗提供参考。方法选取我院2016年1月至2019年6月收治的60例糖尿病合并尿路感染患者为观察组,选取同期我院治疗的60例单纯性糖尿病患者为对照组,分析糖尿病合并尿路感染患者病原菌分布情况,并分析糖尿病患者合并尿路感染的危险因素。结果患者尿路感染病原菌以革兰阴性菌为主(75.00%),其次为革兰阳性菌(20.00%)及真菌(5.00%)。观察组患者住院时间,空腹血糖水平,糖化血红蛋白水平均显著高于对照组;尿液IL-6水平低于对照组(均P<0.05)。观察组患者联合抗生素用药比例高于对照组(P<0.05)。住院时间>15 d、联合应用抗生素、空腹血糖>10.00 mmol/L、糖化血红蛋白>7%以及尿液IL-6水平<48 pg/mL均为糖尿病患者合并尿路感染的独立危险因素。结论糖尿病患者合并尿路感染主要致病菌为革兰阴性菌。住院时间>15 d、联合应用抗生素、空腹血糖过高、糖化血红蛋白过高以及较低的尿液IL-6水平均为糖尿病合并尿路感染的危险因素。

Objective To study the distribution of pathogens in patients with diabetes complicated with urinary tract infection and its influencing factors,so as to provide reference for the treatment of such patients.Methods A total of 60 patients with type 2 diabetes mellitus(T2 DM)complicated with urinary tract infection treated in our hospital from January 2016 to June 2019 were enrolled as observation group,with 60 patients with simple T2 DM treated in our hospital as the control group.The distribution of pathogenic bacteria and the risk factors of urinary tract infection were analyzed.Results The main pathogen of urinary tract infection was Gram-negative bacteria(75.00%),followed by Gram-positive bacteria(20.00%)and fungal infections(5.00%).The hospitalization time,fasting blood sugar level and glycosylated hemoglobin in observation group were significantly higher than those in control group(all P<0.05);The level of IL-6 in urine was lower than that in control group(P<0.05).The combined use of antibiotics in observation group was higher than that in control group(P<0.05).Hospitalization time>15 days,combined use of antibiotics,higher fasting blood glucose>10.00 mmol/L,glycosylated hemoglobin>7%and urinary IL-6 level<48 pg/mL were the independent risk factors for diabetes mellitus complicated with urinary tract infection.Conclusion Gram-negative bacteria are the main pathogens of urinary tract infections in type 2 diabetes mellitus.Hospitalization time>15 days,combined use of antibiotics,high fasting blood sugar,high glycated hemoglobin and low urine IL-6 level are the independent risk factors of diabetes mellitus complicated with urinary tract infections.