老年2型糖尿病合并泌尿系感染的病原学特点及危险因素分析

Etiological characteristics and risk factors of urinary tract infection in elderly patients with type 2 diabetes mellitus

目的研究老年2型糖尿病(T2DM)合并泌尿系感染的病原学特点及危险因素.方法研究对象为北京怀柔医院2019年1月-2020年12月收治的120例T2DM患者,其中60例患者合并泌尿系统感染为研究组,另60例患者未合并泌尿系统感染为对照组,研究组患者均进行病原菌检查及药敏试验,收集两组患者临床资料,明确T2DM合并泌尿系感染的危险因素.结果研究组共检测出63株病原菌,其中革兰阴性菌45株(71.43%),主要为大肠埃希菌,革兰阳性菌6株(9.52%),主要为金黄色葡萄球菌,真菌12株(19.05%),主要为白色念珠菌、白假丝酵母菌;革兰阴性菌对氨苄西林、头孢唑林耐药率较高,对亚胺培南、呋喃妥因的耐药率较低,本次研究检出的革兰阳性菌较少,且以金黄色葡萄球菌为主,此类病原菌对氨苄西林、头孢唑林等耐药率较高.研究组与对照组在导尿、应用抗菌药、空腹血糖及糖化血红蛋白方面存在统计学差异(P<0.05);多因素分析显示,T2DM合并泌尿系统感染的高危因素主要是导尿、糖化血红蛋白水平(P<0.05).结论老年T2DM合并泌尿系感染病原菌以革兰阴性菌为主,导尿、糖化血红蛋白水平等因素是引发泌尿系统感染的高危因素.

Objective To study the etiological characteristics and risk factors of urinary tract infection in elderly patients with type 2 diabetes(T2DM).Methods The subjects were 120 patients with T2DM admitted to our hospital from January 2019 to December 2020.Among them,60 patients with urinary system infection were in the study group,and the other 60 patients without urinary system infection were in the control group.The patients in the study group were all examined for pathogenic bacteria and tested for drug sensitivity.The clinical data of the two groups were collected to identify the risk factors of T2DM with urinary system infection.Results 63 strains of pathogenic bacteria were detected in the study group,including 45 strains of gram negative bacteria(71.43%),mainly Escherichia coli,6 strains of gram positive bacteria(9.52%),mainly Staphylococcus aureus,12 strains of fungi(19.05%),mainly Candida albicans and Candida albicans;gram negative bacteria have high resistance to ampicillin and cefazolin,low resistance to imipenem,high resistance to ampicillin and cefazolin,and low resistance to furantoin and ciprofloxacin;there were statistical differences between the study group and the control group in catheterization,the use of antihacterial agents,fasting blood glucose and glycosylated hemoglobin(P<0.05);multivariate analysis showed that the high risk factors of T2DM complicated with urinary system infection were mainly catheterization and glycosylated hemoglobin level(P<0.05).Conclusion The pathogenic bacteria of elderly T2DM complicated with urinary tract infection are mainly gram-negative bacteria.Factors such as catheterization and glycosylated hemoglobin level are high risk factors forurinary tract infection.