摘要
目的 探讨老年糖尿病患者医院内下呼吸道感染的临床特点及病原学情况。 方法 回顾性调查 85例老年糖尿病合并医院获得性下呼吸道感染患者的临床资料 ,分析病原学及细菌耐药性的特点与糖代谢的关系。 结果 老年糖尿病患者下呼吸道感染的病原菌以革兰阴性杆菌为主 ,占 73 .9% ,主要为铜绿假单胞菌 18.2 %、肺炎克雷伯菌 15.9%、大肠杆菌 14 .8%。 2种细菌混合感染占 14 .1% ,细菌与真菌并存占 6.8%。药物敏感试验提示 :革兰阴性杆菌对抗菌素的敏感性依次为头孢他啶 (Ceftazidime) 72 .3 %、氧氟沙星 (Ofloxacin) 70 .8%、头孢曲松 (Ceftriaxone) 63 .1%、头孢噻肟(Cefotaxime) 61.5%、头孢哌酮 (Cefoperazone ) 61.5%、头孢唑啉 (Cefazolin) 60 .0 %、哌拉西林(Piperacillin) 53 .8%。革兰阳性球菌对万古霉素 10 0 %敏感。对青霉素、红霉素、四环素等呈现不同程度的耐药 ,耐药率在 55%以上。血糖控制不好、基础疾病复杂、伴有并发症的老年糖尿病患者在医院内下呼吸道感染增多 ,且预后不良。 结论 糖尿病患者中医院获得性下呼吸道感染常见 ,病原菌以革兰阴性杆菌为主 。
ObjectiveTo investigate the clinical manifestati on and pathogen of hospital acquired low respiratory tract infection in elderly patients with diabetes.MethodsTo analyze retrospectively th e clinical data, the pathogens isolated from cultured sputum and the antibiotic sensitivity of bacteria in 85 elderly patients with diabetes.Results Bacilli in sputum were common in these patients(73 9%), including Pse udomonas aeruginosa (18 2%), Klebsiella pneumoniae(15 9%), Escherichia co li(14.8%), 14% complicated with 2 different bacilli, 6.8% with fungus. The bac illi sensitive rate to antibiotics was as high as 72.3% to Ceftazidime, 70.8% to Ofloxacin, 63 1% to Ceftriaxone, 61 5% to Cefoperazone or Cefoperazone, 60 .0% to Cefazolin, 53.8% to Piperacillin respectively. Cocci sensitive rate wa s 100% to Vancomycin. Uncontrolled hyperglycemia, severe basic diseases and dia betic complications were involved in the pathogenesis of hospital acquired low respiratory tract infection and the poor prognosis.Conclusion Hospital acquired low respiratory tract infection is common in elderly patient s with diabetes, and should be treated based on the antibiotic sensitivity of ba cteria and on metabolic control.
出处
《中国糖尿病杂志》
CAS
CSCD
2003年第6期409-411,共3页
Chinese Journal of Diabetes
