老年糖尿病患者医院感染病原菌分布及耐药性调查  

Distribution and drug resistance of pathogens causing nosocomial infections in elderly patients with diabetes

作　　者：邱泽安[1] 元延 陈仪坤[3] 

机构地区：[1]贵阳护理职业学院医疗服务中心,贵州贵阳550023 [2]贵阳中医学院第一附属医院检验科,贵州贵阳550023 [3]贵阳护理职业学院医卫管系,贵州贵阳550023

出　　处：《中华医院感染学杂志》2014年第14期3422-3424,共3页Chinese Journal of Nosocomiology

基　　金：贵阳市卫生局重点支持计划基金资助项目(GW-2010A-041)

摘　　要：目的分析医院老年糖尿病患者医院感染的病原菌分布及耐药性,掌握抗菌谱,以指导临床治疗。方法选择2012年3月-2013年3月216例医院感染的老年糖尿病患者,均留取痰液、血液及分泌物进行病原菌培养,采用K-B纸片法进行体外药敏试验,了解病原菌的耐药性。结果老年糖尿病患者以呼吸道感染发生率最高,128例占59.26%,其次为尿路感染和胃肠道感染,分别占19.44%、17.13%;共分离培养出病原菌234株,以革兰阴性菌为主占58.97%,其次是革兰阳性菌占26.07%、真菌占14.96%;革兰阴性菌对头孢类抗菌药物、庆大霉素、哌拉西林等抗菌药物广泛耐药,仅对美罗培南、亚胺培南敏感性较高,革兰阳性菌对万古霉素、替考拉宁感性较高,对其他抗菌药物耐药性较高。结论老年糖尿病患者是医院感染的高危人群,革兰阴性菌是主要感染病原菌,病原菌耐药性日趋严重,真菌感染呈上升趋势是本地区医院感染是主要特点,应引起重视。OBJECTIVE To investigate the distribution and drug resistance of pathogens causing nosocomial infections in the elderly patients with diabetes and grasp the antimicrobial spectrum so as to provide guidance for clinical treatment.METHODS A total of 216elderly patients with diabetes complicated with nosocomial infections,who were treated from Mar 2012to Mar 2013,were recruited in the study,then the sputum,blood,and secretions specimens were sampled for culture of pathogens,and the in vitro drug susceptibility testing was performed with the use of K-B method so as to understand the drug resistance of the pathogens.RESULTS Among the elderly patients with diabetes complicated with nosocomial infections,the patients with respiratory tract infections accounted for 59.26%（128cases）,the patients with urinary tract infections 19.44%,the patients with gastrointestinal tract infections 17.13%.Totally 234strains of pathogens have been isolated,of which 58.97% were the gramnegative bacteria,26.07%the gram-positive bacteria,14.96%the fungi.The gram-negative bacteria showed a broad spectrum of resistance to cephalosporins,gentamicin,and piperacillin and were only susceptible to imipenem and meropenem;the gram-positive bacteria were highly susceptible to vancomycin and teicoplanin but were highly resistant to other antibiotics.CONCLUSION The elderly patients with diabetes are the population at high risk of nosocomial infections;the gram-negative bacteria are the predominant pathogens causing infections;the drug resistance of the pathogens has become increasingly severe.The nosocomial infections in this area is characterized by the up growing of fungal infections,which should be attached great importance to.

关 键 词：老年患者 糖尿病 患者 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]