2型糖尿病并发泌尿系统感染的病原菌分布与耐药性  

Distribution and drug resistance of pathogens in type 2 diabetes mellitus patients combined with urinary system infection

作　　者：李恩杰[1] 田立华[1] 燕东海[1] 李兰元[1] 徐静[1] 王琳琳[1] 

机构地区：[1]泰山医学院附属聊城市第二人民医院,山东临清252600

出　　处：《中国感染控制杂志》2011年第1期53-56,共4页Chinese Journal of Infection Control

摘　　要：目的分析2型糖尿病并发泌尿系统感染的病原菌分布及其耐药性,为临床合理选择抗菌药物提供依据。方法以常规方法分离病原菌,细菌鉴定采用法国生物梅里埃公司VITEK32鉴定到种,K-B纸片扩散法进行体外药敏试验;酵母样真菌的鉴定,采用柯玛嘉念珠菌显色培养基。结果共分离256株病原菌,其中革兰阴性杆菌150株(58.59%),革兰阳性球菌71株(27.74%),酵母样真菌35株(13.67%)。检出的大肠埃希菌、肺炎克雷伯菌产ESBLs率高,分别为42.86%、37.78%;对亚胺培南、美罗培南、哌拉西林/他唑巴坦、阿米卡星、头孢西丁、头孢吡肟有较好的敏感性(耐药率0.00%～29.41%)。检出的凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌属对万古霉素、利奈唑胺、氯霉素等有较好的敏感性(耐药率0.00%～20.00%)。结论革兰阴性杆菌为2型糖尿病并发泌尿系统感染的主要病原菌,真菌感染呈上升趋势。应重视糖尿病合并泌尿系统感染时的病原学检查及药敏结果。Objective To analyze the distribution and drug resistance of pathogens in type 2 diabetes mellitus pa tients combined with urinary system infection, so as to provide reference for rational use of antimicrobial agents. Methyls Pathogens were isolated by routine method, and identified with VITEK32 system , drug susceptibility test was carried out by Kirby-Bauer method, and yeast-like fungi were identified by chromagar. Results A total of 256 pathogens were isolated, 150 （58. 59%） of which were gram-negative bacilli, 71 （27.74%） were gram-positive cocci, 35 （13.67%） were yeast-like fungi. 42. 86% of Escherichia colt and 37. 78% of Klebsiella pneumoniae were extended-spectrum β-lactamase-producing strains, but sensitive to imipenem, meropenem, piperacillin-tazobactam, amikacin, cefoxitin and cefepime were still high, the resistant rate was between 0. 00% - 29. 41%. The isolated co agulase negative Staphylococcus, Staphylococcus aureus and Enterococcus were sensitive to vancomycin, linezolid, and chloramphenicol, the resistant rate was between 0. 00% - 20.00%. Conclusion The main pathogens in type 2 diabetes mellitus patients combined with urinary system infection is gram-negative bacilli , infection with fungi has a rising tendency. Pathogenic detection and drug susceptibility test should be paid attention.

关 键 词：糖尿病 非胰岛素依赖型 泌尿系感染 病原菌 超广谱Β-内酰胺酶 抗菌药物 抗药性 微生物 

分 类 号：R587.1[医药卫生—内分泌]