2型糖尿病患者肺部感染病原菌分布及药物敏感性分析  

Type 2diabetes with lung infection pathogen distribution and drug sensitivity analysis

作　　者：周广举[1] 任伶俐[1] 张园园[2] 

机构地区：[1]川北医学院附属医院内分泌科,四川南充637000 [2]浙江大学医学院附属儿童医院呼吸科,浙江杭州310003

出　　处：《中华医院感染学杂志》2014年第18期4442-4444,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2013KYB152)

摘　　要：目的探讨2型糖尿病合并肺部感染患者的病原菌分布及药物敏感性,为指导临床合理用药提供理论依据。方法选取2010年4月-2013年7月住院患者中2型糖尿病合并肺部感染患者360例,采集所有患者痰及支气管灌洗液标本进行病原菌检测及药敏试验;菌种鉴定采用法国生物梅里埃公司VITEK-60全自动细菌分析仪,药敏试验采用K-B纸片扩散法。结果共分离出病原菌395株,其中革兰阴性菌232株占58.7%,革兰阳性菌129株占32.7%,真菌34株占8.6%;革兰阴性杆菌中铜绿假单胞菌对抗菌药物的耐药率均>60.0%,大肠埃希菌及肺炎克雷伯菌对喹诺酮类、氨基糖苷类、第三代头孢菌素等抗菌物耐药率较高,对亚胺培南、头孢哌酮/舒巴坦、他唑巴坦耐药率较低,均<30.0%;革兰阳性球菌对克林霉素、左氧氟沙星、红霉素、青霉素耐药率较高,均>81.0%;真菌的耐药率普遍较低。结论 2型糖尿病合并肺部感染患者的治疗中进行病原菌鉴定和药敏检测可提高治疗的针对性和有效性,从而避免盲目用药;根据病原菌分布及药敏结果合理使用抗菌药物,以减少新耐药株的形成,同时降低医院感染的发生。OBJECTIVE To investigate the type 2 diabetic patients with pulmonary infection pathogen distribution and drug sensitivity of the situation ,as a guide to provide a theoretical basis for clinical therapy .METHODS From April 2010 to July 2013 ,360 cases of hospitalized patients with type 2 diabetes mellitus patients with lung infec-tions ,sputum and bronchial ravage specimens were collected for pathogen detection and drug susceptibility tes-ting ,including strain identification by the VITEK-60 automatic bacteria analyzer ,drug susceptibility testing was measured by disk diffusion method .RESULTS Gram-negative bacteria were 232（58 .7% ） isolates ,of which Esche-richiacoli 116（29 .4% ） ,Klebsiella pneumonia 74（18 .7% ）;Gram-positive bacteria isolated 129（32 .7% ） ,of which Enterococcus f acials ,were 83（21 .0% ）;fungi 34（8 .6% ） .Among the gram-negative bacilli ,the drug re-sistance rates of E .coli ,and K .Pneumoniae to quinolones ,amino glycosides ,and third-generation cephalosporin were high , and the drug resistance rates to imipenem , cefoperazone/sulbactam , tazobactam were less than 30 .0% ,and the drug resistance rate of Pseudomonas aeruginosa was more than 60 .0% .Gram-positive cocci to clindamycin ,levofloxacin ,erythromycin ,penicillin had a higher resistance ;fungal resistance rate was generally low .CONCLUSION Type 2 diabetes patients with pulmonary infection treatment for pathogen identification and drug susceptibility testing can improve the relevance and effectiveness of the treatment ,thus avoiding blind medi-cation .According pathogen distribution and drug resistance analysis ,antimicrobial drugs should be uses rational-ly ,thereby reducing the formation of new resistant strains and the incidence of nosocomial infections .

关 键 词：糖尿病 肺部感染 病原菌 药敏性 

分 类 号：R378[医药卫生—病原生物学]