终末期糖尿病肾病患者医院感染病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing nosocomial infections in patients with end-stage diabetic nephropathy

作　　者：徐涛[1] 石梅[2] 邱云霞[1] 赵桂东[1] 曲燕[1] 王霞[1] 陈虹[1] 

机构地区：[1]东营胜利石油管理局胜利医院内分泌科,山东东营257055 [2]东营胜利石油管理局胜利医院肾内科,山东东营257055

出　　处：《中华医院感染学杂志》2015年第17期3884-3886,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(Y2006C02)

摘　　要：目的探讨终末期糖尿病肾病(DN)患者医院感染的病原菌分布及耐药性,旨在为DN患者临床抗感染用药提供指导。方法 2010年1月-2014年1月收集150例终末期DN患者血液、尿液、痰液等标本,分离及鉴定病原菌,并进行药敏试验;采用SPSS17.0软件进行统计分析。结果 150例患者中共有40例发生感染,感染率为26.67%;共分离病原菌148株,其中革兰阴性菌65株占43.92%,革兰阳性菌55株占37.16%,真菌28株占18.92%;革兰阴性菌对亚胺培南和哌拉西林的敏感率较高,而对头孢唑林、氨曲南、头孢美唑、头孢他啶的敏感率较低;革兰阳性菌对替考拉宁和万古霉素敏感率均为100.00%,而对头孢唑林、头孢丙烯、磺胺甲噁唑/甲氧苄啶、庆大霉素、链霉素、青霉素、氨苄西林敏感性较低;真菌对常用抗菌药物均表现为较高的敏感性,其中对两性霉素B、氟康唑、氟胞嘧啶敏感性为100.00%。结论终末期DN患者由于免疫功能低下及侵入性操作从而增加患者的医院感染率,对终末期DN患者病原菌分布及耐药性进行分析可为临床用药提供指导。OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing nosocomial infections in the patients with end-stage diabetic nephropathy（DN）so as to provide guidance for clinical use of antibiotics.METHODS From Jan 2010 to Jan 2014,the specimens such as blood,urine,and sputum were collected from 150 patients with end-stage DN,then the isolation and identification of the pathogens were carried out,the drug susceptibility testing was conducted,and the statistical analysis was performed with the use of SPSS17.0software.RESULTS Of the 150 patients,40patients had the infections,with the infection rate of 26.67%.A total of 148 strains of pathogens were isolated,including 65（43.92%）strains of gram-negative bacteria,55（37.16%）strains of gram-positive bacteria,and 28（18.92%）strains of fungi.The drug susceptibility rates of the gram-negative bacteria to imipenem and piperacillin were relatively high,however,the drug susceptibility rates to cefazolin,aztreonam,cefmetazole,and ceftazidime were relatively low.The drug susceptibility rates of the gram-positive bacteria to teicoplanin and vancomycin were 100.00%,while the drug susceptibility rates to cefazolin,cefprozil,sulfamethoxazole-trimethoprim,gentamicin,streptomycin,penicillin,and ampicillin were low.The fungi were highly susceptible to the commonly used antibiotics.CONCLUSION The immunocompromised and invasive operations may result in the increase of incidence of nosocomial infections in the patients with end-stage DN.The analysis of the distribution and drug resistance of the pathogens can provide guidance for the clinical use of antibiotics.

关 键 词：终末期 糖尿病肾病 医院感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]