老年女性糖尿病伴尿路感染患者病原菌分布特点及其耐药性研究  

The distribution characteristics and drug resistance of pathogenic bacteria in elderly female diabetic patients with urinary tract infections

作　　者：申新宏[1] 陶瑾[1] 王焕[1] 

机构地区：[1]河南省新乡市中心医院肾内二科,河南新乡453000

出　　处：《现代预防医学》2013年第24期4503-4505,共3页Modern Preventive Medicine

摘　　要：目的分析某院老年女性糖尿病患者尿路感染致病菌的特点及其耐药性,为抗生素的合理使用提供更多的理论依据。方法收集该院肾内科2009年1月-2011年12月收治的老年女性糖尿病尿路感染患者124例。菌种的鉴定使用VITEK-32全自动细菌鉴定仪。药物敏感试验采用纸片扩散法(Kirby-Bauer)。结果 124例尿液标本中共分离培养出合格菌株84株,阳性率为67.7%,其中革兰阴性菌(G-)62株,占73.8%;革兰阳性菌(G+)20株,占23.8%。革兰阴性菌以大肠埃希菌、肺炎克雷伯杆菌、铜绿假单胞菌和阴沟肠杆菌为主,分别占50.0%、9.5%、7.1%和4.8%。革兰阳性菌以粪肠球菌、金黄色葡萄球菌和表皮葡萄球菌为主,分别占10.7%、5.9%和4.8%。革兰阴性菌对氨苄西林、环丙沙星、庆大霉素、头孢噻肟和头孢他啶的耐药性最高,分别为85.5%、59.7%、58.1%、51.6%和48.4%;对阿米卡星、头孢哌酮、左氧氟沙星、呋喃妥因和亚胺培南的耐药性最低,分别为29.0%、27.4%、32.4%、25.8%和1.6%。革兰阳性菌对青霉素、红霉素、氨苄西林、环丙沙星、左氧氟沙星和庆大霉素的耐药性最高,分别为77.3%、68.2%、54.5%、59.1%、63.6%和45.6%;对呋喃妥因和万古霉素的耐药性最低,分别为22.7%和0%。结论老年女性糖尿病患者尿路感染致病菌主要以革兰阴性菌为主,临床治疗应根据药敏试验结果,合理选择抗生素,以获得最佳治疗效果。OBJECTIVE The study analyzed the characteristics and drug resistance of pathogenic bacteria responsible for uri- nary tract infections in elderly female patients with diabetes mellitus （DM） at our hospital, aiming to provide more theoretical references for the rational use of antibiotics. METHODS 124 elderly female diabetic patients with urinary tract infections visit- ed the nephrology department at our hospital between January of 2009 and December of 2011 were collected. Identification of the pathogen was performed by the VITEK-32 automated microbial identification device, and drug susceptibility of the pathogens was determined by the Kirby-Bauer method. RESULTS 84 qualified strains of bacteria were isolated and cultured from 124 urine specimens, with a positive rate of 67.7%; 73.8% of the strains （62 strains） were tested gram-negative （G-） and 23.8% （20 strains） were gTam-positive （G~）. The gram-negative bacteria were mainly Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Enterobacter cloacae, accounting for 50.0%, 9.5%, 7.1%, and 4.8%, respec- tively; while the gram-positive bacteria were mainly Enterococcus faecalis, Staphylococcus aureus, and Staphylococcus epi- dermidis, accounting for 10.7%, 5.9%, and 4.8%, respectively. The gram-negative bacteria were most resistant against ampicillin, ciprofioxacin, gentamicin, cefotaxime, and ceftazidime, exhibiting a drug resistance rate of 85.5%, 59.7%, 58.1%, 51.6%, and 48.4%, respectively, and had low resistance against amikacin, cefoperazone, levofloxacin, fu- radantin, and imipenem, resulting in a resistance rate of 29.0%, 27.4%, 32.4%, 25.8%, and 1.6%, respectively. The gram-positive bacteria were most resistant against penicillin, erythromycin, ampicillin, ciprofloxacin, levofloxacin, and gentamicin, showing a resistance rate of 77.3%, 68.2%, 54.5%, 59.1%, 63.6%, and 45.6%, respectively, and exhibited low resistance against nitrofurantoin and vancomycin, with the resistance rate being 22.7% and 0%, respectively. CON- CLUS

关 键 词：糖尿病 尿路感染 病原菌 耐药 

分 类 号：R587.1[医药卫生—内分泌]