绍兴地区2型糖尿病尿路感染病原菌及其耐药性  

The distribution of pathogens and drug resistance of urinary tract infections among patients with type 2 diabetes in Shaoxing

作　　者：沈国建[1] 包国祥[1] 王清[1] SHEN Guojian BAO Guoxiang WANG Qing(Clinical laboratory center, Shaoxing peoplels hospital, Shaoxing, Zhejiang 312000, China)

机构地区：[1]绍兴市人民医院临床检验中心,浙江绍兴312000

出　　处：《中国微生态学杂志》2016年第11期1309-1312,共4页Chinese Journal of Microecology

摘　　要：目的回顾分析本院2型糖尿病伴尿路感染患者的病原菌分布特点及其耐药性,为指导临床用药提供参考。方法收集2013年1月至2014年1月2型糖尿病合并尿路感染患者186例,留取中段尿分离培养病原菌,用VITEK-2细菌鉴定仪鉴定,纸片扩散法(K-B)测定药物敏感性。结果 186例患者中段尿共培养出病原菌137株,其中革兰阴性菌102株(74.45%),革兰阳性菌21株(15.33%),真菌14株(10.22%)。革兰阴性菌以大肠埃希菌为主,检出79株占57.66%,对青霉素类,头孢菌素类,喹诺酮类抗菌药耐药率较高均>50.00%,对头霉素类药物如头孢替坦、含酶抑制剂复合物如哌拉西林/他唑巴坦以及碳青霉烯类药物敏感率均达100.00%;革兰阳性球菌以无乳链球菌为主,检出10株占7.30%,对克林霉素及红霉素耐药率较高,耐药率>50.00%,而对氯霉素、呋喃妥因、利奈唑烷、替加环素、万古霉素敏感率均达100.00%。除1株光滑假丝酵母菌对氟康唑和伊曲康唑中介,其余13株真菌对两性霉素B、5-氟胞嘧啶、伏立康唑、氟康唑、伊曲康唑这5种抗真菌药物均敏感。结论 2型糖尿病患者发生尿路感染的病原菌以大肠埃希菌为主,且有较高的耐药率。Objective To analyze the distribution of pathogenic bacteria and drug resistance of urinary tract infections in patients with type 2diabetes in our hospital,to guide the clinical medication.Methods 186 cases of type 2diabetes patients with urinary tract infection from January 2013 to January 2014 were collected;their midstream specimens of urine were cultured for identification of pathogenic bacteria by using VITEK-2bacterial identification instrument and for test of drug sensitivity by using disk diffusion（K-B）method.Results A total of137 strains of bacteria were detected,including 102 Gram negative bacteria（74.45%）,21 Gram positive bacteria（15.33%）,and 14fungi（10.22%）.Most of the Gram negative bacteria were Escherichia coli,accounting for 57.66%（79strains）;the resistance rates to penicillins,cephalosporins and quinolones were higher than 50.00%,and the sensitivity rate to cefotetan,piperacillin/tazobactam and carbapenems were100.00%.The main Gram positive cocci was Streptococcus agalactiae,accounting for 7.30%（10strains）;the resistance rates to clindamycin and erythromycin were higher than 50.00%,while the sensitivity rates to chloramphenicol,nitrofurantoin,linezolid,tigecycline and vancomycin were 100.00%.The fungi were sensitive to amphotericin B,5-flucytosine,voriconazole,fluconazole and itraconazole,except 1strain of Candida which showed intermediary resistance to fluconazole and itraconazole.Conclusion In patients with type 2diabetes,urinary tract infections were mainly caused by highly resistant Escherichia coli.

关 键 词：2型糖尿病 尿路感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]