2型糖尿病合并败血症患者病原菌分布及药物敏感性分析

Distribution and drug sensitivity of pathogens in patients with type 2 diabetes mellitus complicated by sepsis

目的探讨2型糖尿病合并败血症患者的病原菌种类及其对抗菌药物的敏感性。方法回顾性分析仪陇县人民医院2017年7月至2020年7月收治的2型糖尿病合并败血症患者139例的临床资料,总结其病原菌分布及其药物敏感性。结果139例患者中共检测到139株病原菌,其中革兰阴性菌105株[75.5%(105/139)],革兰阳性34株[24.5%(34/139)],真菌0株[0.0%(0/139)]。革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌以葡萄球菌属为主,其中以金黄色葡萄球菌、肠球菌、人葡萄球菌亚种多见。医院感染和社区感染常见病原菌均为大肠埃希菌、肺炎克雷伯菌。常见革兰阴性病原菌对头孢唑林、氨苄西林、头孢他啶、头孢曲松、妥布霉素、复方磺胺甲噁唑的耐药性较高;常见革兰阳性菌对青霉素、红霉素、克拉霉素的耐药性较高。结论2型糖尿病合并败血症患者病死率较高,病原菌以革兰阴性菌为主,大肠埃希菌和肺炎克雷伯菌是最常见的病原菌。同时应重视原发感染部位对2型糖尿病合并败血症的影响。

Objective To investigate the types of pathogenic bacteria and their sensitivity to antibiotics in patients with type 2 diabetes mellitus complicated by sepsis.Methods The clinical data of 139 patients with type 2 diabetes mellitus complicated by sepsis who received treatment in People's Hospital of Yilong from July 2017 to July 2020 were retrospectively analyzed.The distribution and drug sensitivity of pathogenic bacteria were also analyzed.Results A total of 139 strains of pathogens were detected in 139 patients,including 105 strains of gram-negative bacteria[75.5%(105/139)],34 strains of gram-positive bacteria[24.5%(34/139)],and 0 strain of fungi[0.0%(0/139)].Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae;gram-positive bacteria were mainly Staphylococcus,among which Staphylococcus aureus,Enterococcus and human Staphylococcus subspecies were more common.Escherichia coli and Klebsiella pneumoniae were the common pathogens of hospital-and community-onset bacteremia.The common gram-negative bacteria were highly resistant to cefazolin,ampicillin,ceftazidime,ceftriaxone,tobramycin and compound sulfamethoxazole.The common gram-positive bacteria were highly resistant to penicillin,erythromycin and clarithromycin.Conclusion Patients with type 2 diabetes mellitus complicated by sepsis have a high mortality,with gram-negative bacteria as the main pathogen.Escherichia coli and Klebsiella pneumoniae are the most common pathogens in such patients.At the same time,more attention should be paid to the influence of primary infection site on type 2 diabetes mellitus complicated by sepsis.