2型糖尿病患者多重耐药菌感染情况分析

Analysis of multi-drug resistant bacterial infections in patients with type 2 diabetes

目的分析2型糖尿病患者多重耐药菌感染情况。方法将某院2021年2月~2023年11月收治的326例2型糖尿病患者临床资料进行回顾性分析,所有患者均进行血液、痰液、尿液、分泌物的培养鉴别并分析病原菌株及耐药性等特点,分析主要革兰阴性菌、阳性菌及真菌的药敏情况。结果326例患者分离出301株病原菌:革兰阴性菌182株占60.47%;革兰阳性菌87株占28.90%;真菌32株占10.63%。多重耐药菌106例,60岁以上感染患者占总感染患者例数的54.82%;大肠埃希菌、金黄色葡萄球菌、表皮葡萄球菌为主要病原菌,其中大肠埃希菌耐药率较高的抗菌药物为氨苄西林、呋喃妥因,耐药率分别为96.12%、73.64%。3种革兰阳性菌未出现耐万古霉素、利奈唑胺、利福平菌株。结论2型糖尿病患者病原菌分布十分广泛,患者极易发生感染,其中老年患者占比较高,病原菌耐药性普遍较强,存在高耐药性、多重耐药性,因此应及时对患者病原菌进行检测,针对性用药,有助于提高临床疗效。

Objective To analyse the multi-drug-resistant bacterial infections in patients with type 2 diabetes mellitus.Methods The clinical data of 326 patients with type 2 diabetes mellitus admitted to a hospital from February 2021 to November 2023 were retrospectively analyzed,and all patients underwent culture of blood,sputum,urine,and secretions to identify and analyze the characteristics of pathogenic bacterial strains and resistance,and to analyze the drug sensitivity of the major gram-negative bacteria,positive bacteria,and fungi.Results 301 strains of pathogenic bacteria were isolated from 326 patients:182 strains of gram-negative bacteria accounted for 60.47%;87 strains of gram-positive bacteria accounted for 28.90%;and 32 strains of fungi accounted for 10.63%.There were 106 cases of multidrug-resistant bacteria,and the number of infected patients over 60 years old accounted for 54.82%of the total number of infected patients;Escherichia coli,Staphylococcus aureus,and Staphylococcus epidermidis were the main pathogens,among which the antimicrobial drugs with high resistance rate of Escherichia coli were ampicillin and furaztoxin,and the resistance rates were 96.12%and 73.64%respectively.Three of the gram-positive bacterias did not show vancomycin-resistont、linezolid-resistant and rifampicin-resistant strains.Conclusion The distribution of pathogenic bacteria in patients with type 2 diabetes mellitus is very wide,and patients are very susceptible to infections,among which the proportion of elderly patients is relatively high,and the resistance of pathogenic bacteria is generally strong,and there exists a high drug resistance and multi-drug resistance,therefore,timely detection of pathogenic bacteria in patients should be carried out,and targeted medication can help to improve the clinical efficacy.