老年女性糖尿病患者尿路感染病原菌的体外耐药性监测  

In vitro bacterial resistance monitoring of urinary tract infections in female elderly patients

作　　者：林广玲[1] 陈林兴[1] 林美珊[1] 辜红妮[1] 刘波[1] 

机构地区：[1]汕头大学医学院第二附属医院检验科,515041

出　　处：《中国综合临床》2011年第3期264-266,共3页Clinical Medicine of China

摘　　要：目的探讨老年女性糖尿病患者尿路感染病原菌的分布情况及耐药特征，为临床合理使用抗菌素提供依据。方法收集老年女性糖尿病患者尿路感染病原菌107株，采用法国梅里埃公司VITEK32分析仪进行细菌鉴定和体外药敏试验。结果107株病原菌中，革兰阴性杆菌感染占74．8％（80／107），以大肠埃希菌为主，占48．6（52／107）；革兰阳性球菌占13．1％（14／107）；真菌占12．1％（13／107）。革兰阴性杆菌对氨苄西林、头孢唑啉、头孢呋辛钠、头孢呋辛酯耐药率均高于70．0％，对亚胺培南、丁胺卡那霉素耐药率均低于10．0％。革兰阳性球菌对万古霉素、利奈唑烷耐药率分别为0和7．1％（1／14）。结论老年女性糖尿病患者尿路感染主要病原菌是大肠埃希菌，该菌耐药性较强，临床上应加强糖尿病患者尿路感染病原菌的检测和耐药性监测。Objective To determine the distribution and antibiotics resistance characteristic of pathogens in urinary tract infections in aged female diabetics patients and provide scientific basis for clinicians in selecting effective antibiotics. Methods Pathogenic bacteria, isolated from specimens of 107 elderly female diabetic cases with urinary tract infections, were identified and drug susceptibility tests were performed by VITEK-32 analysator. Results Among all 107 kinds of isolated bacteria,the ratio of gram-negative bacteria was 74. 8% （ 80/107 ）, predominated by Escherichiacoli （ accounting for 48. 6% [ 52/107 ] ） ; the ratio of gramposition bacterias was 13, 1% （14/107） and eumycetes was 12. 1% （13/107）. In antibiotic resistance analysis, the gram negative bacteria showed higher drug-resistance to the some common-antibiotics, such as ampicililin, cefazolin,cefuroxime-sodium and cefuroxime axetil （ 〉 70. 0% ）, while they were sensitive to imipenem and amikacin（ 〈 10. 0% ）. The gram positive bacteria were most sensitive to vancomycin （0%）, followed by Linezolid（7.7% ）. Conclusion Escherichiacoli were the major pathogenic bacteria in urinary tract infections in aged female diabetic patients, with higher drug resistance. Therefore, drug resistance monitoring should be carried out according to the variety of pathogenic bacteria so as to guide rational use of antibiotics and decrease drug resistance.

关 键 词：糖尿病 尿路感染 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]