妊娠期糖尿病患者并发尿路感染的影响因素及中段尿病原菌分布特征分析  

Analysis of the influencing factors of urinary tract infection in pregnant women with diabetes and the distribution characteristics of pathogens in the middle urinary tract

作　　者：傅丽群[1] 李永明[1] 赵小云 Fu Liqun;Li Yongming;Zhao Xiaoyun(Department of Obstetrics,the Second People′s Hospital of Lianyungang,Lianyungang 222000,China;Department of Gynecology,the Second People′s Hospital of Lianyungang,Lianyungang 222000,China)

机构地区：[1]连云港市第二人民医院产科,连云港222000 [2]连云港市第二人民医院妇科,连云港222000

出　　处：《中国医师杂志》2023年第8期1225-1228,共4页Journal of Chinese Physician

摘　　要：目的探讨妊娠期糖尿病患者并发尿路感染的影响因素及中段尿病原菌分布特征。方法选取2018年12月至2021年12月期间在连云港市第二人民医院就诊的220例妊娠期糖尿病患者作为研究对象,统计尿路感染发生率,根据尿路感染确诊结果分为感染组和未感染组,感染组采取中段尿进行病原菌培养,分析主要革兰阴性杆菌对抗菌药物的耐药率,采用logistic回归模型分析妊娠期糖尿病患者尿路感染的影响因素。结果220例妊娠期糖尿病患者中发生尿路感染者共32例,感染率为14.55%(32/220),其中共鉴定出43株病原菌,主要为革兰阴性杆菌[72.09%(31/43)],其次是革兰阳性球菌[20.93%(9/43)]和真菌[6.98%(3/43)]。主要的革兰阴性杆菌中大肠埃希菌对氨苄西林、左氧氟沙星耐药率较高,肺炎克雷伯菌对氨苄西林、头孢唑林耐药率高。感染组与非感染组在年龄、住院时间、个人尿路感染史、妊娠期性生活史、抗菌药物使用情况、空腹血糖、血清白蛋白、糖化血红蛋白方面比较差异均有统计学意义(均P<0.05);多因素logistic回归结果显示,有个人尿路感染史、妊娠期有性生活、未规范使用抗菌药物、血清白蛋白<30 g/L、糖化血红蛋白≥7%、空腹血糖≥8.5 mmol/L是妊娠期糖尿病患者尿路感染的独立危险因素(均P<0.05)。结论妊娠期糖尿病患者存在较高的尿路感染发生率,危险因素复杂,革兰阴性杆菌为主要致病菌,临床上可根据药敏试验合理选择抗菌药物进行干预。Objective To investigate the influencing factors of urinary tract infection in pregnant women with diabetes and the distribution characteristics of pathogens in the middle urinary tract.Methods A total of 220 patients with gestational diabetes who visited the Second People′s Hospital of Lianyungang City from December 2018 to December 2021 were selected as the study subjects,and the incidence of urinary tract infection was counted.According to the diagnosis results of urinary tract infection,they were divided into infected group and uninfected group.The infected group took the middle urine for pathogen culture,and the resistance rate of main gram-negative bacteria to antibiotics was analyzed;Logistic regression model was used to analyze the influencing factors of urinary tract infection in pregnant women with diabetes.Results There were 32 cases of urinary tract infection in 220 patients with gestational diabetes,and the infection rate was 14.55%(32/220).43 strains of pathogenic bacteria were identified,mainly gram-negative bacilli[72.09%(31/43)],followed by gram-positive cocci[20.93%(9/43)]and fungi[6.98%(3/43)].Amongthe main gram-negative bacteria,escherichia coli had a high resistance rate to ampicillin and levofloxacin,while Klebsiella pneumoniae had a high resistance rate to ampicillin and cefazolin;There were significant differences between the infected group and the non infected group in age,hospital stay,personal urinary tract infection history,pregnancy sexual life history,use of antibiotics,fasting blood sugar,serum albumin,and glycated hemoglobin(all P<0.05);Multivariate logistic regression results showed that personal history of urinary tract infection,sexual life during pregnancy,non-standard use of antibiotics,serum albumin<30 g/L,glycated hemoglobin≥7%,and fasting blood sugar≥8.5 mmol/L were independent risk factors for urinary tract infection in pregnant diabetes patients(all P<0.05).Conclusions There is a high incidence of urinary tract infection in patients with gestational diabetes,and the

关 键 词：糖尿病 妊娠 泌尿道感染 细菌分型技术 

分 类 号：R714.256[医药卫生—妇产科学]