2型糖尿病合并肺部感染患者临床分析  

Clinical analysis of hospitalized patients with type 2 diabetes complicated by pulmonary infection in Fujian Provincial Hospital

作　　者：沈小燕[1,2] 陈刚[1] 林丽香[1] 

机构地区：[1]福建医科大学省立临床学院,福州350001 [2]厦门市第二医院内分泌科

出　　处：《中国糖尿病杂志》2009年第12期935-938,共4页Chinese Journal of Diabetes

摘　　要：目的了解T2DM合并肺部感染患者的致病菌分布及药敏情况,比较社区获得性肺炎(CAP)和医院获得性肺炎(HAP)病原谱差异和耐药强弱。方法分析我院1995年1月至2006年10月收治的T2DM合并肺部感染患者的痰培养和血培养致病菌及药敏测定结果。结果 494例痰培养致病菌分布为:革兰阳性球菌73株,占16.7%;革兰阴性杆菌139株,占31.9%;真菌224株,占51.4%。CAP组和HAP组均以真菌和革兰阴性杆菌为主,两组对多种抗生素耐药性较高,HAP组明显高于CAP组。结论 2型糖尿病患者合并CAP与HAP病原菌均以真菌和革兰阴性杆菌为多见,两组病原谱和耐药情况存在统计学差异。临床应重视2型糖尿病合并肺部感染患者痰培养及抗生素的合理使用。Objective To determine the causative organisms and antimicrobial susceptibility of community-and hospital-acquired pneumonia （CAP and HAP） in type 2 diabetes in Fujian Provincial Hospital. Methods The data of becteria spectrum and their drug susceptibility in patients with type 2 diabetes complicated by pulmonary infection were retrospectively analyzed in January 1995 to October 2006. Results The isolated bacteria of sputum culture of 494 cases included 73 gram-positive cocci （16.7%）, 139 gram negative bacilli（31.9%）and 224 fungus（51.4%）. G＋ cocci mainly included staphylococci, G-bacilli mainly included Klebsiella pneumoniae, Bowman immovability bacillus and Pseudomonas aeruginosa. In both CAP and HAP,fungus and G- bacilli were the dominant pathogens. The pathogenic bacteria were resistant to multi-antibiotics, and the resistant rates from HAP patients was higher than those from CAP. Of the bacterial strains isolated from blood culture, G-bacilli constituted 87.5%. Conclusions Fungus and G-bacilli were the dominant pathogens. Phlegm culture and drug sensitive test are helpful for reasonable use of antibiotics for patients with type 2 diabetes complicated by pulmonary infection in clinical practice.

关 键 词：糖尿病 2型 肺部感染 药物敏感性试验 

分 类 号：R587.1[医药卫生—内分泌] R378[医药卫生—内科学]