糖尿病并发尿路感染患者的病原菌分布情况及其耐药性分析  

Distribution of pathogenic bacteria and antimicrobial resistance in diabetic patients complicated with urinary tract infection

作　　者：刘继清 王升[2] 李艳红[1] Liu Jiqing;Wang Sheng;Li Yanhong(Department of Medical Laboratory,Anyang District Hospital of Puyang,Aanyang 455000,China;Clinical Laboratory,Anyang District Hospital of Puyang,Aanyang 455000,China)

机构地区：[1]河南省濮阳市安阳地区医院医学检验科,安阳455000 [2]河南省濮阳市安阳地区医院临床实验室,安阳455000

出　　处：《临床医学》2022年第1期11-13,共3页Clinical Medicine

摘　　要：目的探讨糖尿病并发尿路感染患者的病原菌分布情况及其耐药性分析。方法选取2019年8月至2020年11月濮阳市安阳地区医院糖尿病并发尿路感染患者96例,均采集尿液标本,行病原菌培养和药敏试验,分析糖尿病并发尿路感染患者病原菌分布和主要病原菌对抗菌药物耐药性。结果 96份尿液标本中,共分离出118株病原菌;革兰阴性菌85株,占比72.03%,以大肠埃希菌(61.02%)、肺炎克雷伯菌(5.93%)为主;革兰阳性菌24株,占比20.34%,以粪肠球菌(7.63%)、无乳链球菌(6.78%)为主;真菌9株,占比7.63%。大肠埃希菌对哌拉西林、氨苄西林、环丙沙星耐药率较高;肺炎克雷伯菌对氨苄西林、头孢西丁、头孢哌酮、头孢唑啉耐药率较高;二者对美洛培南、厄他培南均无耐药性。粪肠球菌对青霉素、环丙沙星、利福平耐药率较高;无乳链球菌对利福平耐药率较高;二者对万古霉素无耐药性。结论糖尿病并发尿路感染患者多为革兰阴性菌感染,其次为革兰阳性菌,且不同病原菌对各个抗菌药物耐药性存在差异,临床应结合耐药性检测结果,合理使用抗菌药物,以提高抗菌效果。Objective To investigate the distribution of pathogenic bacteria and analysis of antimicrobial resistance in patients with diabetes complicated with urinary tract infection.Methods From August 2019 to November 2020,96 patients with diabetes complicated with urinary tract infection in Anyang District Hospital of Puyang were selected,urine samples were collected,pathogen culture and drug sensitivity test were carried out,and the distribution of pathogens and antimicrobial resistance of main pathogens in patients with diabetes complicated with urinary tract infection were analyzed. Results A total of 118 strains of pathogenic bacteria were isolated from 96 urine samples;85 strains of gram-negative bacteria,accounting for 72. 03%,mainly Escherichia coli( 61. 02%) and Klebsiella pneumoniae( 5. 93%);24 strains of gram-positive bacteria,accounting for 20. 34%,mainly Enterococcus faecalis( 7. 63%) and Streptococcus agalactiae( 6. 78%);9 strains of fungi,accounting for 7. 63%. The resistance rate of Escherichia coli to piperacillin,ampicillin and ciprofloxacin was higher. The resistance rate of Klebsiella pneumoniae to ampicillin,cefoxitin,cefoperazone and cefazolin was higher. Both of them had no drug resistance to meropenem and ertapenem. The resistance rate of Enterococcus faecalis to penicillin,ciprofloxacin and rifampicin was higher. Streptococcus agalactiae has higher drug resistance rate to rifampicin. They were not resistant to vancomycin. Conclusions Most patients with diabetes complicated with urinary tract infection are infected by Gram-negative bacteria,followed by Gram-positive bacteria,and there are differences in the drug resistance of different pathogenic bacteria to various antibiotics. Therefore,it is necessary to use antibiotics rationally in order to improve the antibacterial effect.

关 键 词：糖尿病 尿路感染 病原菌分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R587.2[医药卫生—临床医学] R691.3