Material Basis of Ningmitai Capsule for the Treatment of Urinary Tract Infections Based on Network Pharmacology

[Objectives]To study the main active components,targets and related pathways of Ningmitai capsule for the treatment of urinary tract infections(UTIs)based on network pharmacology.[Methods]The chemical components of Ningmitai capsule were collected through literature search,and the relevant target information of the components was sorted out.The UTIs-associated targets were also screened out using DisGeNET database and GeneCards database.Cytoscape 3.6.1 software and STRING platform were used to construct the protein-protein interaction(PPI)network,and MCODE plug-in in this software was used to analyze the action pathway and key targets of Ningmitai capsule for the treatment of UTIs.GO and KEGG pathway enrichment analysis of key targets was conducted using David database,and the component-target-pathway network diagram of Ningmitai capsule for the treatment of UTIs was established.[Results]A total of 37 active compounds,including salicylate,ferulic acid,baicalin,quercetin,apigenin and ellagic acid were screened from seven TCM components of Ningmitai capsule.There were 26 possible targets related to the treatment of UTIs,such as NFKB1,JUN,CTNNB1 and STAT3,which play an important role for the treatment of UTIs through prostate cancer,bladder cancer,pancreatic cancer and other signaling pathways.[Conclusions]The study provides a theoretical basis for the study of the mechanism of Ningmitai capsule in the treatment of UTIs.

Recurrence of urinary tract infections in postmenopausal diabetic women using different antibiotics

Objectives: Postmenopausal women with diabetes mellitus (DM) have an increased incidence of urinary tract infections (UTI) compared to women without DM. The aim of this study is to compare recurrence rates of UTI in postmenopausal women with DM after treatment with nitrofurantoin, the agent of first choice following the Dutch guidelines, with two other common prescribed antibiotics trimethoprim and norfloxacin. Methods: We used a PHARMO database with pharmacy dispensing data. A total of 8534 postmenopausal (>55 years) women with DM who received a first course of nitrofurantoin, trimethoprim or norfloxacin were included. The UTI recurrence rates after treatment with these three different antimicrobial agents were compared. Recurrence was defined as a second prescription for nitrofurantoin, trimethoprim or norfloxacin or a first with fosfomycin, amoxicillin, fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion. Results: Postmenopausal women with DM had significantly more UTI recurrences when they were treated with nitrofurantoin (22.7%) compared to trimethoprim (17.7%) or norfloxacin (14.2%) irrespective of the treatment duration. There was a trend that longer treatment duration was associated with higher recurrence rates. Conclusions: Postmenopausal women with DM had more UTI recurrences when they are treated with nitrofurantoin, agent of first choice, compared to trimethoprim or norfloxacin.

Epidemiological, Clinical, Paraclinical and Evolutionary Aspects of Urinary Tract Infection in Diabetics Hospitalized at the Department of Medicine of Abass Ndao Hospital from January 01, 2018, to December 31, 2018

Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.

Urgent call for attention to diabetes-associated hospital infections

In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.

Prevalence of Drug Resistant Uropathogenic Escherichia coli from Immunocompromised Diabetic Patients Attending Selected Health Facilities in Benue State

Escherichia coli is the commonest bacterial uropathogen of UTIs, the commonest infections in immunocompromised diabetic patients. Better understanding of their main resistance mechanisms to commonly used antibacterial agents will help to reduce the burden of this infection. The prevalence of drug resistant uropathogenic Escherichia coli isolates from immunocompromised diabetic patients attending selected health facilities in Benue State was investigated. Two hundred and ninety-six midstream urine samples were collected for both study and control diabetic patients. Bacterial isolation was done using semi-quantitative method. Drug resistant Escherichia coli were identified as multidrug resistant (MDR), extensive drug resistant (XDR) and pan-drug resistant organisms (PDR). Statistical significance was considered at p E. coli isolates from the study and control subjects with overall prevalence of 20.9% and 8.4% respectively. The isolates were highly resistant to penicillin (ampicillin), monobactam (aztreonam), older quinolone (nalidixic acid) whereas the majority of them showed high susceptibility to aminoglycoside (streptomycin), cephalosporin (cefotaxime) and carbapenem (imipenem). None showed complete susceptibility to all the tested antibiotics. Twenty-five E. coli were identified in this MDR, eight, XDR while 5 were PDR. High numbers of drug resistant E. coli isolates were identified in the study group of which 25 were MDR, 8 XDR while 5 were PDR isolates. High prevalence of UTI and drug resistant isolates occur in diabetic patients with hyperglycemic condition.

Asymptomatic Bacteriuria and Urinary Tract Infection in Pregnant Women with and without Diabetes Mellitus and Gestational Diabetes Mellitus—A Case-Control Study

Background: Asymptomatic bacteriuria (ASB) and urinary tract infections (UTI) during pregnancy may contribute to adverse pregnancy outcomes. Diabetes mellitus (DM) and gestational diabetes mellitus (GDM) are considered to be important additional risk factor for ASB and UTI during pregnancy. Aims: To investigate differences in prevalence of ASB and incidence of UTI in pregnant women with and without DM and GDM to inform ASB screening and treatment policies. Methods: Data from 214 pregnant women who gave birth during 2010 at the Women’s and Children’s Hospital, Adelaide, Australia where cases were women with a clinical diagnosis of (G)DM and controls were matched on date of birth. ASB was defined as the growth of at least 10e5 colony forming units/ml of one organism or any presence of group B streptococcus (GBS) at the first urine culture collected during pregnancy without complaints of a UTI. A clinical UTI was diagnosed by the treating physician, in combination with a positive urine culture it was defined as culture-confirmed UTI. Results: No significant differences in prevalence of ASB (5.6% and 3.7%;relative risk (RR) 1.50;95% confidence intervals (CI) 0.44 - 5.17), incidence of clinical UTI (4.7% and 11.2%;RR 0.42;95% CI 0.15 - 1.14) or culture-confirmed UTI (2.8% and 3.7%;RR 0.75;95% CI 0.17 - 3.27) between pregnant women with and without (G)DM were present. No association was found between ASB and UTI. GBS was the most common causative organism of ASB in women with and without DM (66.7% and 50.0%). Conclusion: In contrast with earlier research, no significant differences in prevalence of ASB or incidence of UTI was found between pregnant women with and without (G)DM.

Clino-Pathological Features of Urinary Tract Infection in Rural India

The study was aimed to understand the clino-pathological characteristics of urinary tract infection along with the techniques used in diagnosis and treatment of the presenting infection. The study takes into consideration the various risk factors such as age, sex, and diabetes mellitus which can precipitate a urinary tract infection. The study was conducted at the Global Baroda Hospital, Vadodara and Narhari Hospital, Vadodara in the duration from January to March 2012, under the supervision of Dr. Hiten Kareliya. A questionnaire was prepared in accordance to evaluate risk factors of urinary tract infection. The patients under study were chosen according to specific inclusion criteria. The uropathogens were isolated with the help of biochemical testing. E. coli (38%) was found to be the most prevalent organism followed by Klebsiella and Candida albicans (both 10%), Pseudomonas aeruginosa (9%), Staphylococcus (7%).

八宝丹胶囊预防导尿管相关性尿路感染的效果

目的:探讨八宝丹胶囊预防导尿管相关性尿路感染(CAUTI)的效果。方法:选择2022年6月至2023年2月于郑州大学第一附属医院泌尿外科就诊且留置导尿管的患者。根据治疗方案分为3组,留置导尿管后静脉给予抗生素(拉氧头孢钠)者为对照组(n=73),给予八宝丹胶囊者为试验组A(n=72),给予八宝丹胶囊联合抗生素者为试验组B(n=72)。在留置导尿管第3、5、7天及拔除导尿管48 h行尿常规、尿培养检查,比较各组总CAUTI发生率、膀胱过度活动症(OAB)发生率及不良反应发生率。结果:对照组、试验组A、试验组B总CAUTI发生率分别为39.7%、36.1%、20.8%,OAB发生率分别为30.1%、18.1%、11.1%,试验组B总CAUTI发生率、OAB发生率低于对照组(P<0.017)。3组治疗期间均未发生不良反应。结论:八宝丹胶囊联合抗生素使用可有效预防CAUTI发生,并且具有良好的安全性。

糖尿病合并尿路感染患者酮症酸中毒的影响因素分析

目的探讨2型糖尿病合并尿路感染患者糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的临床特点及影响因素,为DKA预防及早期干预提供参考。方法回顾性收集2022年1月至2023年9月天门市第一人民医院收治的糖尿病合并尿路感染患者的病历资料,根据住院期间是否发生DKA分为DKA组和非DKA组,比较分析DKA发生的影响因素。结果共纳入137例患者,其中DKA组35例、非DKA组102例,DKA发生率为25.55%,两组患者在年龄以及空腹血糖、糖化血红蛋白(HbA1c)、血清降钙素原(PCT)、尿白细胞水平方面差异均具有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≥60岁[OR=2.369,95%CI(1.013,5.541)]、血清PCT≥0.5 ng·L-1[OR=3.234,95%CI(1.215,8.609)]、HbA1c≥7%[OR=2.958,95%CI(1.130,7.743)]是糖尿病合并尿路感染者发生DKA的危险因素。结论年龄≥60岁、血清PCT≥0.5 ng·L-1及HbA1c≥7%是糖尿病合并尿路感染者发生DKA的独立危险因素,临床医生应及时识别,尽早预防。

血尿安胶囊联合左氧氟沙星治疗女性尿路感染疗效及对患者炎症因子影响

目的:探究女性尿路感染(UTI)患者应用血尿安胶囊联合左氧氟沙星治疗效果及对炎症因子及不良反应影响.方法:选取2020年6月-2023年2月本院妇科收治的160例UTI患者,随机数字表法分成观察组、对照组各80例,两组均给予左氧氟沙星治疗,观察组加以血尿安胶囊治疗,治疗2个月.观察用药后两组临床疗效、尿液指标、炎症水平、阴道PH值以及不良反应.结果:治疗后,观察组临床疗效(92.5%)高于对照组(81.3%),两组尿白细胞数与尿细菌数均下降且观察组(3.44±1.02个/HP、665.45±122.53个/μl)低于对照组(7.67±2.11个/HP、934.61±158.35个/μl),两组用药后C-反应蛋白、高迁移率族蛋白B1及降钙素原水平均下降且观察组(12.32±5.45mg/L、60.04±12.44ng/ml、0.54±0.12ng/ml)低于对照组(20.32±8.78mg/L、82.63±15.51ng/ml、2.13±0.43ng/ml),两组阴道PH值均下降且用药后观察组(4.54±0.77)低于对照组(5.23±0.85),不良反应总发生率观察组(7.5%)低于对照组(18.8%)(均P<0.05).结论:血尿安胶囊联合左氧氟沙星可提高UTI临床疗效,有效减轻患者炎症,降低阴道PH值和用药不良反应.

儿童糖尿病合并尿路感染的临床特征及危险因素分析

目的探讨儿童糖尿病(DM)合并尿路感染(UTI)的临床特征和危险因素。方法160例儿童DM患者根据并发泌尿系感染分为UTI组和非UTI组,每组80例。收集儿童DM并发泌尿系感染的临床资料,包括DM类型、性别、年龄、体质量指数(BMI)、病程、住院时间、是否留置尿管、是否酮症酸中毒、抗生素及胰岛素使用情况、尿液标本分离细菌类型及入院时各项化验指标等结果,并进行分析。结果UTI组病原菌主要包括大肠埃希菌(37株,46.3%)、肠球菌(21株,26.2%)、肺炎克雷伯菌(9株,11.2%)等。单因素分析显示2组间肥胖、病程、住院时间、是否留置导尿管、是否酮症酸中毒、抗生素使用情况、糖化血红蛋白(HbA1c)、白蛋白(ALB)及血肌酐(Cr)的差异有统计学意义(P<0.05)。多因素分析显示DM合并UTI的危险因素包括住院时间延长(OR=2.087,95%CI:1.562~2.789)、留置导尿管(OR=15.886,95%CI:2.336~108.007)、酮症酸中毒(OR=9.300,95%CI:1.169~73.992)、病程≥36个月(OR=20.548,95%CI:2.425~174.119)、HbA1c升高(OR=16.686,95%CI:3.666~75.955)及血Cr升高(OR=1.010,95%CI:1.002~1.019);而血清ALB升高(OR=0.799,95%CI:0.702~0.910)为其保护因素。结论儿童DM合并UTI以大肠埃希菌感染为主,与住院时间、留置尿管、酮症酸中毒、病程时间、HbA1c、血Cr和ALB水平密切相关。

宁泌泰胶囊治疗上尿路结石术后残余结石的临床疗效观察

目的:探讨宁泌泰胶囊在促进5~20mm的上尿路结石输尿管软镜钬激光碎石术后残余结石的排出及并发症方面的效果。方法:回顾性分析重庆医科大学附属第一医院2023年2月至2023年5月接受肾或输尿管结石手术的患者。按照纳入研究的患者术后服用药物种类分为2组,分别为:宁泌泰组及对照组。观察的结局指标有结石排出率,结石排净率,同时比较2组术后第1天及第14天血尿和尿路感染情况。另外,本研究还对6项随机对照试验进行了荟萃分析,以验证结果。结果:回顾性研究的结果表明,宁泌泰组患者术后14d的结石排出率(P=0.024)和排净率(P=0.002)均高于对照组,而2组患者术后第一天和第14天尿液中红细胞计数及白细胞计数并不存在统计学上的差异。对6项已发表的随机对照试验进行荟萃分析的结果同样表明,宁泌泰组比对照组的结石排出率和排净率高。同时还得出宁泌泰组患者结石排出和排净都更快,发生肾绞痛和使用镇痛药物的概率也较低。结论:宁泌泰胶囊对促进泌尿系结石术后残余结石的排出存在一定效果,可以降低患者术后发生肾绞痛的风险,但对于降低患者术后尿路感染和血尿的风险仍需进一步研究。

癃清胶囊抗尿路感染临床研究及网络药理学作用机制探索

目的通过临床研究和网络药理学探析癃清胶囊抗尿路感染的疗效和机制。方法选取西医确诊为单纯性尿路感染,且中医辨证为下焦湿热证的女性患者60例,将其随机分为对照组和试验组,每组30例。2组在均给予头孢克洛口服治疗基础上,试验组口服癃清胶囊,对照组口服癃清胶囊模拟剂。治疗7 d后,比较2组临床症状评分、生活质量评分、单项症状消失时间、总有效率及安全性指标。利用TCMSP和Swiss Target Prediction数据库获取癃清胶囊的活性成分及潜在作用靶点,通过GeneCards数据库获取尿路感染的相关靶点,筛选共同靶点,运用Cytoscape构建“活性成分-靶点”网络;通过STRING数据库构建PPI网络并通过DAVID数据库进行KEGG和GO分析。结果与对照组相比,试验组尿急症状评分、生活质量评分及单项症状消失时间均降低(P均<0.05),治疗总有效率提高(P<0.05)。网络药理学结果显示槲皮素、山柰酚等是癃清胶囊抗尿路感染的主要有效成分,SRC、PIK3R1、HSP90AA1等基因为其抗尿路感染的核心靶点,且主要富集在癌症相关通路、MAPK等信号通路上。结论癃清胶囊可能通过癌症相关通路等信号通路发挥抗尿路感染作用,可改善尿频、尿急、尿痛等症状,提高生活质量。

老年糖尿病患者合并尿路感染风险预测模型构建

目的 探究老年糖尿病患者合并尿路感染(UTI)的相关因素,并构建风险预测模型,为糖尿病患者UTI预防方案的制定提供参考。方法 选取2021年1月至2023年1月于成都医学院第一附属医院住院的331例老年糖尿病患者为研究对象,根据有无UTI感染分为合并UTI组(n=63)、未合并UTI组(n=268),分析相关影响因素并建立风险预测模型,并经列线图可视化处理,评估模型的预测价值。结果 合并UTI组尿比重、尿白细胞计数、 24 h微量白蛋白和FPG>7 mmol/L占比、HbA1c>6.5%占比及2 h空腹血糖(FPG)水平明显高于未合并UTI组(P<0.05)。年龄≥65岁、糖尿病病程≥10年、有并发症、留置导尿管、FPG>7 mmol/L是患者合并UTI发生的危险因素,预防性使用抗生素是保护因素(P<0.05)。预测模型的AUC为0.957,敏感性、特异性分别为85.71%、95.15%,Bootstrap内部验证及校准曲线分析显示,模型区分度、校准度、准确度良好。结论 高龄、糖尿病病程≥10年、有并发症、FPG>7 mmol/L和留置导尿管是老年糖尿病患者合并UTI发生风险增高的主要原因,风险预测模型可有效预测患者UTI的发生。

糖化血红蛋白对2型糖尿病患者尿路感染病原菌的影响

目的 探讨糖化血红蛋白(HbA1c)对2型糖尿病(T2DM)患者尿路感染病原菌的分布和耐药情况是否存在影响。方法 选取2021年9月—2022年9月天津医科大学朱宪彝纪念医院160例尿培养阳性的T2DM住院患者。根据HbA1c检测结果分为A组(5.5%9.0%,76例)。比较2个组尿路感染病原菌的分布和耐药性差异。结果 160例T2DM合并尿路感染患者中共分离出182株病原菌。2个组革兰阴性杆菌检出率均最高(分别为69.38%和64.29%),菌株类型主要为大肠埃希菌(>50.00%)。A组革兰阳性菌和真菌检出率分别为16.33%和14.29%;B组革兰阳性菌和真菌检出率分别为10.71%和25.00%。B组大肠埃希菌对妥布霉素和氨苄西林-舒巴坦的耐药率高于A组(P<0.05);B组多重耐药大肠埃希菌检出率高于A组(P=0.046)。结论 高HbA1c水平T2DM合并尿路感染患者真菌检出率较高;T2DM合并尿路感染患者大肠埃希菌对部分抗菌药物的耐药性随HbA1c水平升高而增加。

赵文景教授运用栝楼瞿麦丸类方治疗糖尿病合并再发性下尿路感染经验

糖尿病合并再发性下尿路感染迁延难愈,常对多种抗生素耐药,治疗困难,极大影响了患者的身体健康及生活质量。赵文景教授认为糖尿病合并再发性下尿路感染的病机主要为肾阳亏虚,肾-命门-三焦气化失司,从阳虚为本、阳不化气出发,基于“肾—命门—三焦气化”理论,探讨运用栝楼瞿麦丸类方培补命门、调理肾、膀胱与三焦的功能以复气化,随证选用泻心栝楼瞿麦丸、补中栝楼瞿麦丸、化瘀栝楼瞿麦丸、解郁栝楼瞿麦丸、温下栝楼瞿麦丸等进行治疗,以期为中医药诊治糖尿病合并再发性下尿路感染提供新思路。

Emphysematous Cystitis: Report of Two Cases and Review of the Literature

Emphysematous cystitis is a rare complication of lower urinary tract infection whose prognosis is conditioned by the delay in treatment. The predisposition of diabetic patients to urinary infections caused by gas-producing bacteria is considered one of the most common factors in the occurrence of emphysematous cystitis. The currently recommended diagnostic test is CT scanning, which has definite value in assessing gas accumulation in the bladder wall and lumen. The authors report the observations of two patients aged 68 and 80 who were treated for emphysematous cystitis complicating diabetes mellitus. The evolution was favorable under treatment with antibiotic therapy, insulin therapy and bladder drainage.

2型糖尿病合并泌尿系感染联合预测模型的构建与验证

目的建立2型糖尿病合并泌尿系感染(urinary tract infection,UTI)的列线图预测模型,为早期诊断UTI提供依据。方法回顾性分析310例2型糖尿病患者临床资料,将其分为训练集217例和验证集93例。单因素和多因素logistic回归分析2型糖尿病患者发生UTI的危险因素,构建基于危险因素的列线图模型,并验证其准确性和可靠性。结果310例2型糖尿病患者发生UTI 63例,UTI发生率20.3%;训练集UTI 41例占18.9%,验证集UTI 22例占23.7%。多因素回归分析结果显示,体重指数、C反应蛋白、白蛋白、糖化血红蛋白是影响2型糖尿病患者发生UTI的独立危险因素(P<0.05)。验证结果显示,列线图模型在训练集与验证集的C指数分别为0.971和0.917,AUC为0.816和0.788,特异度为80.28%和71.59%,敏感度为77.27%和75.61%。结论利用危险因素构建的列线图模型可有效预测2型糖尿病患者UTI发生风险,帮助医护人员制订针对性管理方案。

215例高龄T2DM合并尿路感染患者病原菌分布及耐药性分析

目的:分析215例高龄2型糖尿病(T2DM)合并尿路感染患者病原菌分布及耐药性。方法:回顾性分析2021年3月至2023年3月该院收治的215例高龄T2DM合并尿路感染患者的临床资料。收集患者尿液标本行病原菌培养、药敏试验,统计高龄T2DM合并尿路感染患者病原菌分布情况,分析主要革兰阴性菌、革兰阳性菌对抗菌药物的耐药性。结果:215例高龄T2DM合并尿路感染患者尿液标本中共分离出病原菌221株,其中革兰阴性菌177株,占比最高(80.10%),以大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌为主;革兰阳性菌38株,占17.19%,以粪肠球菌为主;真菌6株,占2.71%。大肠埃希菌对氨苄西林耐药性最高(56.91%),其次是哌拉西林(53.66%)、依替米星(51.22%),对阿米卡星、他唑巴坦耐药性较低(均<10%),对亚胺培南不耐药;肺炎克雷伯菌对环丙沙星、氨苄西林的耐药性最高(均为55.00%),对亚胺培南不耐药。粪肠球菌对四环素耐药性最高(82.35%),其次是红霉素、环丙沙星、链霉素(均为58.82%)及氯霉素(52.94%),对青霉素G、氨苄西林、万古霉素不耐药。结论:高龄T2DM合并尿路感染患者感染病原菌以革兰阴性菌为主,其中大肠埃希菌占比最高,对氨苄西林、哌拉西林、依替米星耐药性高。

2型糖尿病患者泌尿系统感染病原菌的构成特点及耐药性分析

目的探讨2型糖尿病患者泌尿系统感染病原菌的构成特点及耐药情况,为临床用药治疗提供参考依据。方法对2020年1月—2023年8月南明区人民医院收治的107例2型糖尿病合并泌尿系统感染患者资料进行回顾性分析,统计泌尿系统感染病原菌的构成以及耐药情况,并比较不同性别之间病原菌和耐药性的差异。结果107例患者清洁中段尿标本共检出109株病原菌,其中革兰氏阴性菌占80.7%(88株),革兰氏阳性菌和念珠菌分别占14.7%(16株)及4.6%(5株),大肠埃希菌是最常见的致病菌,不同性别感染病原菌的构成情况具有差异,女性患者大肠埃希菌的检出率高于男性。药敏结果显示,大肠埃希菌对多种抗菌药物的耐药率超过60.0%,对亚胺培南100%敏感;粪肠球菌对万古霉素和利奈唑胺100%敏感;大肠埃希菌对氨苄西林和环丙沙星的耐药率明显高于粪肠球菌(P<0.05),对呋喃妥因的耐药率却低于粪肠球菌(P<0.05)。不同性别检出的大肠埃希菌对常用抗菌药物的耐药率差异无统计学意义(P>0.05)。结论2型糖尿病患者泌尿系统感染病原菌主要是革兰氏阴性菌,其中大肠埃希菌是最常见的致病菌。不同性别的患者感染病原菌的构成有所不同,不同病原菌之间对抗菌药物的耐药率具有差异,而不同性别患者检出的主要病原菌对常用抗菌药物的耐药率无明显差异,临床应根据病原菌培养及药敏结果,合理选择抗菌药物治疗。