摘要
目的：探讨研究2型糖尿病患者（T2DM）合并尿路感染（UTI）的病原菌分布及其耐药性分析，指导临床合理使用抗生素。方法对2006年1月-2013年10月在笔者医院内分泌科住院的311例T2DM进行病原学鉴定及药敏分析。结果311例T2DM合并白细胞尿患者经中段尿培养分离出335株阳性致病菌，其中无症状性菌尿占尿路感染的69．45％。致病菌分布中革兰阴性菌株（G^－）占65．37％，以大肠杆菌为主，占48．96％，其次为变形菌属。革兰阳性菌株（G^＋）占25．67％，以肠球菌属为主，占11．94％，其次为无乳链球菌。真菌感染率为8．36％。药敏试验表明大肠杆菌对环丙沙星、氨苄西林、左旋氧氟沙星的耐药率高；变形菌属对复方新诺明、呋喃妥因、氯霉素的耐药率高；肠球菌属对复方新诺明、红霉素、环丙沙星的耐药率高；无乳链球菌对复方新诺明、环丙沙星的耐药率高。结论近年来2型糖尿病合并尿路感染患者中无症状性菌尿占主导地位，其病原菌分布中，大肠杆菌仍占首位，且比例逐年升高趋势，对传统抗生素耐药性明显，应高度重视，根据药敏结果合理使用抗生素。
Objective To investigate the distribution and drug-resistance analysis of pathogens in type 2 diabetic patients compli-cated with urinary tract infection in order to guide clinical rational use of antibiotics.Methods The clinical data of 311 cases of T2DM complicated with urinary tract infection, from Jan 2006 to Oct 2013, were collected from inpatient of endocrine department in our hospital. Results A total of 335 pathogenic bacteria were found, and asymptomatic bacteriuria （ASB） accounted for 69.45%in urinary infection. These were 65.37%gram negative bacteria, 25.67%gram positive bacteria, and 8.36% fungi.Among gram negative bacteria, E.coli rated the first （48.96%）, followed by proteus.Among gram positive bacteria enterococcus generarated the first （11.94%） followed by Streptococcus agalactiae.E.coli was highly resistant to ciprofloxacin, ampicillin and levofloxacin.Proteus was highly resistant to TMP-SMZ,nitrofurantion and chloramphenicol.Enterococcus was highly resistant toTMP-SMZ, erythromycin and ciprofloxacin.Streptococcus agalactiae was obviously resistant to TMP-SMZ and ciprofloxacin.Conclusion In recent years, asymptomatic bacteriuria is dominant in type 2 diabetic patients with urinary tract infection.In its distribution of pathogens, E.coli still accounts for the first, and the ratio increa-ses year by year.We should attach great importance to the fact that E.coli resist to the traditional antibiotic obviously, so asymptomatic bacteriuria in type 2 diabetes mellitus should be treated actively.
出处
《医学研究杂志》
2015年第7期113-117,共5页
Journal of Medical Research
关键词
2型糖尿病
尿路感染
无症状性菌尿
致病菌
Type 2 diabetes mellitus
Urinary tract infection
Asymptomatic bacteriuria
Pathogenic bacteria
