2型糖尿病合并尿路感染的病原菌分布及药敏分析  

The Characteristics and Drug—resistance of the Pathogenic Bacteria Isolated from Type 2 Diabetics Patients Complicated with Urinary Tract Infection

作　　者：阮璐雅[1] 倪连松[1] 郑景晨[1] 吴积升[2] 

机构地区：[1]温州医学院附属第一医院内分泌科,325000 [2]温州市第二人民医院药剂科,325000

出　　处：《医学研究杂志》2011年第11期136-139,共4页Journal of Medical Research

摘　　要：目的探讨2型糖尿病患者(T2DM)合并尿路感染(UTI)的病原菌分布和对抗菌药物的耐药情况,指导临床合理应用抗生素。方法对2006年1月～2009年12月在笔者医院内分泌科住院的T2DM合并UTI患者进行病原学鉴定及药敏试验。结果 243例T2DM合并白细胞尿患者经中段尿培养检出162例阳性致病菌,致病菌检出率为66.67%,其中无症状性菌尿占尿路感染的66.05%。致病菌分布中革兰阴性菌株(G-)占59.26%,以大肠杆菌为主,占42.60%;其次为变形菌属,革兰阳性菌株(G+)占34.57%,以肠球菌属为主,占17.28%,而后为缺乳链球菌,真菌感染率为6.17%。药敏试验表明大肠杆菌对氨苄西林、环丙沙星、复方新诺明的耐药率高;肠球菌对复方新诺明、红霉素和环丙沙星的耐药率高;缺乳链球菌对复方新诺明、四环素的耐药明显。结论近年来T2DM合并UTI的病原菌种类中大肠杆菌仍占首位,但比例有所下降,肠球菌属和念珠菌属有明显上升趋势,应高度重视;对传统抗生素耐药性明显,应根据药敏结果合理使用抗生素;建议可对T2DM患者的无症状性菌尿行积极治疗。Objective To investigate the characteristics and drug-resistance of the pathogenic bacteria isolated from patients with type 2 diabetics（T2DM）complicated with urinary tract infection（UTI）. Methods From Jan 2006 to Dec 2009,243 urine specimens were collected from inpatient of endocrine department in our hospital. Totally 162 strains of pathogens were identified and drugresistant were analyzed retrospectively. Results A tatal of 162 pathogenic bacteria（66.67% ） were isolated from 243 cases, and asymptomatic bacteriuria （ASB） accounted for 66.05% in urinary infection. These were 59.26% gram negative bacteria,34.57% gram positive bacteria,and 6. 17% fungi. Among gram negative bacteria, E. coli rated the first （42.60%） , followed by proteus. Among gram positive bacteria, enterococcus genera rated the first （17.28%） ,followed by S treptococcus agalactiae. E. coli was highly resistant to ampicilfin, eiprofloxacin andTMP - SMZ. Enterococcus was highly resistant to TMP - SMZ, erythromycin and ciprofloxacin S treptococcus agalactiae was obviously re- sistant to TMP - SMZ and tetracycline. Conclusion The T2DM patients complicated with UT[ were mainly infected by gram negative bacteria but the proportion declined. Enterococcus and fungi infection had an obviously increasingly tendency ,which should be carefully treated. Appropriate antibiotic drugs should be chosen according to drug -resistant characteristic of the pathogenic bacteria. Asymptomatic bacteriuria in type 2 diabetes mellitus can be treated actively.

关 键 词：2型糖尿病 尿路感染 无症状性菌尿 致病菌 抗菌素 

分 类 号：R259[医药卫生—中西医结合]