2型糖尿病患者并发医院感染病原菌及血液学指标研究  

Distribution of pathogens isolated from type 2 diabetes mellitus patients complicated with nosocomial infections and haematological indexes

作　　者：王修峰[1] 王允[1] 肖琳[1] 刘晶[1] 史维青 

机构地区：[1]邹城市人民医院医院感染管理办公室,邹城山东273502

出　　处：《中华医院感染学杂志》2017年第13期2995-2998,共4页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅基金资助项目(20150341)

摘　　要：目的分析2型糖尿病医院感染的病原菌分布及感染部位情况,探讨细胞因子在2型糖尿病患者发生医院感染时的变化。方法回顾性分析2015年1月-2016年9月在医院住院治疗2型糖尿病患者临床资料;依据患者是否发生医院感染将患者分为感染组(93例)及非感染组(98例),同时纳入同期健康体检者为对照组(60例);采用微生物全自动鉴定仪进行病原菌鉴定分型,比较各组细胞因子指标水平。结果 93例感染组患者共分离致病菌108株,其中革兰阴性菌53株占49.07%,革兰阳性菌44株占40.74%,真菌11株占10.19%;2型糖尿病医院感染的主要部位是肺部及上呼吸道占34.29%;感染组患者白细胞计数(WBC)(8.5±2.7×109/L)、C-反应蛋白(CRP)(23.7±6.9mg/L)、白介素-6(IL-6)(25.4±4.5ng/L)水平显著高于未感染组患者和对照组,差异有统计学意义(P<0.05);感染组患者胰岛素样生长因子-1(IGF-1)(102.5±28.1ng/L)水平显著低于未感染组和对照组,差异有统计学意义(P<0.05)。结论 2型糖尿病患者医院感染以革兰阴性菌为主,并且感染主要部位为肺部及上呼吸道,同时监测患者细胞因子的变化,有效控制2型糖尿病医院感染。OBJECTIVE To observe the distribution of pathogens isolated from type 2 diabetes mellitus patients complicated with nosocomial infections,analyze the infection sites,and explore the change of cytokines in the type 2 diabetes mellitus patients complicated with nosocomial infections.METHODS The clinical data of the patients with type 2 diabetes mellitus who were hospitalized for treatment from Jan 2015 to Sep 2016 were retrospectively analyzed,the enrolled patients were divided into the infection group with 93 cases and the non-infections group with 98 cases according to the status of nosocomial infection,meanwhile,60 healthy people who received physical examination were included and set as the control group.The pathogens were identified by using microorganism automatic identification system,and the levels of cytokines indexes were observed and compared.RESULTS A total of108 strains of pathogens were isolated from the 93 patients with infections,of which 53（49.07%）were gramnegative bacteria,44（40.74%）were gram-positive bacteria,and 11（10.19%）were fungi.Among the type 2 diabetes mellitus patients complicated with nosocomial infections,34.29% had lung and upper respiratory tract infections.The levels of white blood cell（WBC）counts（8.5±2.7×10^9/L）,C-reactive protein（CRP）（23.7±6.9mg/L）,and interleukin-6（IL-6）（25.4±4.5ng/L）were significantly higher in the infection group than in the non-infection group and the control group（P〈0.05）.The insulin-like growth factor-1（IGF-1）level（102.5±28.1ng/L）of the infection group was significantly lower than that of the non-infection group and the control group（P〈0.05）.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens causing the nosocomial infections in the type 2 diabetes mellitus patients,the lung and upper respiratory tract are the major infection sites,and the monitoring of change of cytokines may facilitate the effective control of the nosocomial infections.

关 键 词：2型糖尿病 医院感染 病原菌分布 细胞因子 

分 类 号：R378[医药卫生—病原生物学]