老年糖尿病肾病合并泌尿系感染病原菌分布及耐药性分析  

Pathogenic bacteria distribution and drug resistance analysis of aged diabetic nephropathy associated with urinary infection

作　　者：周大金 练冬 徐哲民 

机构地区：[1]浙江省丽水市第二人民医院,浙江丽水323000

出　　处：《中国微生态学杂志》2016年第5期581-583,593,共4页Chinese Journal of Microecology

摘　　要：目的探讨老年糖尿病肾病合并泌尿系感染病原菌的分布及其耐药性,为临床合理用药提供依据。方法回顾性分析2012年1月～2014年12月医院内分泌科老年糖尿病肾病合并泌尿系感染患者临床资料,采用WHONET 5.4软件进行统计分析处理。结果共分离出病原菌381株：革兰阴性菌256株,前四位分别为大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌和奇异变形杆菌;革兰阳性菌82株,前三位分别为肠球菌属、表皮葡萄球菌和金黄色葡萄球菌;真菌32株,细菌L型11株。药敏结果显示,主要革兰阴性菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星和亚胺培南耐药率较低,主要革兰阳性菌对呋喃妥因、万古霉素和替考拉宁耐药率较低。结论革兰阴性菌是老年糖尿病肾病合并泌尿系感染患者的主要致病菌,不同致病菌对抗菌药物耐药率差别较大,合理使用抗菌药物对有效控制感染尤为重要。Objective To explore the distribution and drug resistance of pathogenic bacteria from aged diabetic nephropathy associated with urinary tract infection,so as to provide evidence for reasonable clinical use of antibiotics.Methods The clinical data of aged diabetic nephropathy associated with urinary tract infection patients who were treated in the department of endocrinology from Jan.2012 to Dec.2014 were retrospectively analyzed,the statistical analysis was carried out by WHONET 5.4software.Results A total of 381 strains of pathogens were isolated,including 256 strains of Gram-negative bacteria,the top four pathogens were Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae and Proteus mirabilis.There were 82 strains of Gram-positive bacteria,the top three pathogens were Enterococcus,Staphylococcus epidermidis,and Staphylococcus aureus.There were 32 strains of fungi and 11 strains of L form.The drug sensitive tests showed that the main gram-negative bacteria showed low drug resistance rate to cefoperazone/sulbactam,piperacillin/tazobactam,amikacin and imipenem,the main gram-positive bacteria showed low drug resistance rate to nitrofurantoin,vancomycin and teicoplanin.Conclusion The Gram-negative bacteria are dominant bacteria in aged diabetic nephropathy associated with urinary tract infection.Different bacteria have different drug resistance,rational use of antibiotics is very important to control urinary tract infection.

关 键 词：老年人 糖尿病肾病 生殖泌尿系统 感染 耐药性 

分 类 号：R512.62[医药卫生—内科学]