2型糖尿病合并血流感染的病原菌分布特点及耐药性分析  

Analysis of pathogen distribution characteristics and drug resistance in type 2 diabetes complicated with bloodstream infection

作　　者：倪孝兵 谭伟 郑文静 章诗琪[1] 胡红琳[1] NI Xiaobing;TAN Wei;ZHENG Wenjing;ZHANG Shiqi;HU Honglin(The First Affiliated Hospital of Anhui Medical University,Department of Endocrinology and Metabolism,Hefei 230031,China;Xuancheng People's Hospital Infectious Disease Department)

机构地区：[1]安徽医科大学第一附属医院内分泌代谢科,安徽合肥230031 [2]宣城市人民医院感染科

出　　处：《中国病原生物学杂志》2025年第3期383-387,共5页Journal of Pathogen Biology

摘　　要：目的探讨2型糖尿病患者并发血流感染病原菌的分布规律及其耐药情况,为临床合理应用抗菌药物提供依据。方法选取63例在本院就诊的2型糖尿病合并血流感染患者为本次研究对象,对临床资料进行回顾性分析,对其血培养阳性的病原菌进行分离鉴定,并对主要病原菌进行耐药性测试。检测血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平,对比不同感染病原菌类型患者血清IL-6、IL-10水平。结果在63例合并血流感染患者中,31例原发感染部位为泌尿系统,12例为呼吸系统,9例为消化系统,5例为皮肤软组织,颅内、导管相关性感染、原发病灶不明各占2例。男性患者中,泌尿系统、呼吸系统、消化系统的感染比例分别为33.33%、25%、16.67%;女性患者比例分别为58.97%、15.38%、12.82%。泌尿系统作为原发感染部位的性别差异具有统计学意义(P<0.05),而其他部位的差异则无统计学意义(P>0.05)。在63例2型糖尿病合并血流感染患者中,共分离出63株病原菌。其中,革兰阴性菌占63.49%,主要为大肠埃希菌(30.16%)、肺炎克雷伯菌(14.29%)、铜绿假单胞菌(9.52%)、鲍曼不动杆菌(6.35%)等。革兰阳性菌占34.92%,以金黄色葡萄球菌(17.46%)为主。真菌仅占1.59%,为白色假丝酵母菌。在63例非糖尿病合并血流感染患者中,革兰阴性菌占58.73%,革兰阳性菌占38.1%,真菌占3.17%。对比两组患者,仅金黄色葡萄球菌的构成比差异有统计学意义(P<0.05),其他病原菌构成比差异无统计学意义(P>0.05)。2型糖尿病合并血流感染组检出40株革兰阴性菌,对左氧氟沙星等耐药率高于50%,对亚胺培南等低于20%。非糖尿病组37株革兰阴性菌,对左氧氟沙星等耐药率高于50%,对哌拉西林/他唑巴坦等低于20%。两组对头孢他啶、头孢吡肟、阿米卡星耐药率差异显著(P<0.05),其他药物无显著差异(P>0.05)。2型糖尿病合并血流感染组检出22株革兰阳性菌,对�Objective To explore the distribution pattern and drug resistance of pathogens causing bloodstream infections in patients with type 2 diabetes,so as to provide a basis for the rational clinical application of antibacterial drugs.Methods 63 patients with type 2 diabetes complicated with bloodstream infection who were treated in our hospital were selected as the research objects for this study.The clinical data were retrospectively analyzed.The pathogenic bacteria with positive blood culture were isolated and identified,and the drug resistance of major pathogenic bacteria was tested.The levels of serum interleukin-6(IL-6)and interleukin-10(IL-10)were detected,and the levels of serum IL-6 and IL-10 in patients with different types of infectious pathogens were compared1..ResultsAmongthe63 patients with bloodstream infection,the primary infection sites of 31 cases were urinary system,12 cases were respiratory system,9 cases were digestive system,5 cases were skin and soft tissue,and 2 cases each were intracranial,catheter-related infection and unknown primary lesion.Among male patients,the infection proportions of urinary system,respiratory system and digestive system were 33.33%,25%and 16.67%respectively;among female patients,the proportions were 58.97%,15.38%and 12.82%respectively.The gender difference in urinary system as the primary infection site was statistically significant(P<0.05),while the differences in other sites were not statistically significant(P>0.05).Among 63 patients with type 2 diabetes complicated with bloodstream infection,a total of 63 strains of pathogenic bacteria were isolated.Among them,Gram-negative bacteria accounted for 63.49%,mainly Escherichia coli(30.16%),Klebsiella pneumoniae(14.29%),Pseudomonas aeruginosa(9.52%),Acinetobacter baumanni(6.35%),etc.Grampositive bacteria accounted for 34.92%,mainly Staphylococcus aureus(17.46%).Fungi accounted for only 1.59%,which was Candida albicans.Among 63 patients without diabetes complicated with bloodstream infection,Gram-negative bacteria accounte

关 键 词：2型糖尿病 血流感染 病原菌 耐药性 

分 类 号：R44[医药卫生—诊断学]