糖尿病肾病患者感染病原菌耐药性分析与对肾功能的影响研究

发布时间：2018-05-04 03:33

本文选题：糖尿病 + 肾病　；参考：《中华医院感染学杂志》2016年02期

【摘要】：目的研究糖尿病肾病患者感染病原菌耐药性及其对肾功能的影响,为临床治疗提供参考。方法选取医院2010年1月-2014年1月诊治的520例糖尿病肾病感染患者为研究对象,采用法国生物梅里埃公司的API鉴定系统及全自动微生物鉴定系统进行病原菌鉴定,采用美国MicroScan AutoScan4药敏测试系统进行药敏试验,按是否检出病原菌将患者分为感染组303例、未感染组217例,并以同期150名健康体检者作为对照组,对比分析3组人员肌酐、尿素氮及微量蛋白尿水平;采用WHONE5.5软件和SPSS20.0软件对数据进行统计分析。结果共分离出病原菌302株,其中革兰阳性菌134株占44.4%,以金黄色葡萄球菌、G型溶血性链球菌和酿脓链球菌为主,革兰阴性菌168株占55.6%,以大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌为主;革兰阳性菌对红霉素、头孢西丁、头孢唑林、青霉素、林可霉素等均有较强的耐药性,但对万古霉素均较敏感,革兰阴性菌对头孢唑林、头孢呋辛、头孢西丁、头孢他啶、环丙沙星等均有较强的耐药性,但对亚胺培南较敏感;感染患者的血清肌酐、尿素氮及微量蛋白尿水平明显升高。结论糖尿病肾病患者易感染病原菌,对常用抗菌药物有较强耐药性,且明显影响患者的肾功能。
[Abstract]:Objective to study the resistance of pathogenic bacteria to diabetic nephropathy and its influence on renal function, and to provide reference for clinical treatment. Methods from January 2010 to January 2014, 520 patients with diabetic nephropathy infection were selected as the study objects. The API identification system and the automatic microbial identification system of French Bio-Meridier Company were used to identify the pathogenic bacteria. The patients were divided into infection group (303 cases) and uninfected group (217 cases) according to whether pathogenic bacteria were detected, and 150 healthy persons were used as control group in the same period. The creatinine levels in 3 groups were compared and analyzed. Urea nitrogen and microalbuminuria were analyzed by WHONE5.5 and SPSS20.0 software. Results A total of 302 strains of pathogenic bacteria were isolated, of which 134 were Gram-positive bacteria (44.4%), mainly Staphylococcus aureus G hemolytic streptococcus and Streptococcus pyogenes, 168 Gram-negative bacteria (55.6%) and Escherichia coli (EC). Pseudomonas aeruginosa and Klebsiella pneumoniae were dominant, Gram-positive bacteria had strong resistance to erythromycin, cefoxitin, cefazolin, penicillin and lincomycin, but were sensitive to vancomycin, and Gram-negative bacteria were resistant to cefazolin. Cefuroxime, cefoxitin, ceftazidime and ciprofloxacin were all highly resistant, but sensitive to imipenem, and serum creatinine, urea nitrogen and microalbuminuria were significantly increased in infected patients. Conclusion Diabetic nephropathy patients are susceptible to infection of pathogenic bacteria and have strong resistance to common antimicrobial agents, and obviously affect the renal function of patients.
【作者单位】：武穴市第一人民医院内科;武穴市第一人民医院重症医学科;武穴市第一人民医院药剂科;
【基金】：湖北省科技厅基金资助项目(2014CDB013)
【分类号】：R446.5

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