台州市立医院健康体检糖尿病患者泌尿系统感染状况

发布时间：2018-06-28 06:27

本文选题：泌尿系统感染 + 糖尿病　；参考：《中华医院感染学杂志》2017年06期

【摘要】：目的探讨医院健康体检糖尿病患者泌尿系统感染情况,为糖尿病患者泌尿系统感染预防和治疗提供依据。方法筛选2013年1月-2016年3月在医院符合条件的糖尿病患者538例为研究对象,分析糖尿病患者泌尿系统感染率和病原菌分部情况。结果 538例糖尿病患者中共有58例病原菌培养阳性,感染率为10.78%;58例泌尿系统感染患者共分离出62株病原菌;其中革兰阴性杆菌37株,占59.68%,革兰阳性球菌21株,占33.87%,真菌4株,占6.45%;革兰阴性菌大肠埃希菌对氨苄西林、头孢他啶、头孢呋辛等的耐药率均在65%以上;肺炎克雷伯杆菌对氨苄西林、头孢呋辛、哌拉西林、头孢噻肟的耐药率均在65%以上;奇异变形杆菌对氨苄西林、头孢他啶、哌拉西林、头孢噻肟的耐药率均在65%以上;大肠埃希菌、肺炎克雷伯杆菌、奇异变形杆菌对亚胺培南100%敏感,对头孢哌酮/舒巴坦的耐药性均不高于25%;革兰阳性菌中粪肠球菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌对青霉素和红霉素的耐药率均在70%以上,但都对万古霉素100%敏感;白假丝酵母菌对氟康唑、两性霉素B、制霉菌素、伊曲康唑、酮康唑均较敏感。结论糖尿病患者易发生泌尿系统感染,且病原菌对抗菌药物耐药性较为严重,临床应根据药敏试验选择合适的抗菌药进行感染治疗。
[Abstract]:Objective to investigate the urinary system infection of diabetic patients in hospital health examination, and to provide evidence for the prevention and treatment of urinary tract infection in diabetic patients. Methods 538 patients with diabetes mellitus were selected from January 2013 to March 2016. The infection rate of urinary system and the distribution of pathogenic bacteria in diabetic patients were analyzed. Results of the 538 patients with diabetes mellitus, 58 cases were positive for pathogen culture, and the infection rate was 10.78%. A total of 62 strains of pathogenic bacteria were isolated from 58 patients with urinary system infection, among which 37 strains of Gram-negative bacilli (59.68%), 21 strains of Gram-positive cocci (33.87%) and 4 strains of fungi. The resistance rates of Escherichia coli to ampicillin, ceftazidime and cefuroxime were over 65%, and the resistance rates of Klebsiella pneumoniae to ampicillin, cefuroxime, piperacillin and cefotaxime were over 65%. The resistance rates of Proteus mirabilis to ampicillin, ceftazidime, piperacillin and cefotaxime were over 65%, and Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were sensitive to imipenem 100%. The drug resistance of Enterococcus faecalis, Staphylococcus aureus and coagulase-negative staphylococcus to penicillin and erythromycin in Gram-positive bacteria were over 70%, but sensitive to vancomycin 100%. Candida albicans were sensitive to fluconazole, amphotericin B, nystatin, itraconazole and ketoconazole. Conclusion Diabetes mellitus patients are prone to urinary tract infection and the pathogens are more resistant to antimicrobial agents. The appropriate antibiotics should be selected according to the drug sensitivity test.
【作者单位】：台州市立医院体检中心;
【基金】：浙江省医药科技计划基金资助项目(20157283)
【分类号】：R587.2;R691.3

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