老年女性糖尿病合并尿路感染281例的临床特征及病原菌分析  

Clinical characteristics and pathogen analysis of 281 elderly female diabetic patients complicated with urinary tract infection

作　　者：陈丽坤 林发全[1] 朱虹贞[2] CHEN Likun;LIN Faquan;ZHU Hongzhen(Department of Clinical Laboratory,the First Affiliated Hospital of Guangxi Medical University/Key Laboratory Diagnostics of Clinical Laboratory Medicine of the Guangxi Universities,Nanning 530021,Guangxi,China;Department of Clinical Laboratory,Liuzhou Worker's Hospital,Liuzhou 545005,Guangxi,China)

机构地区：[1]广西医科大学第一附属医院检验科/广西高校临床检验诊断学重点实验室,广西南宁530021 [2]广西柳州市工人医院检验科,广西柳州545005

出　　处：《右江医学》2025年第3期221-226,共6页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-B20221481)。

摘　　要：目的探讨老年女性糖尿病合并尿路感染的临床特征,并分析病原菌的分布情况及其耐药性。方法选取老年女性糖尿病合并尿路感染281例患者作为研究对象,回顾性分析患者的临床特征、尿培养结果及药敏试验。结果(1)从临床表现来看,入组病例有尿路感染相关症状者仅占49.5%,约一半的病例无典型症状;(2)共培养出病原菌313株,以革兰氏阴性菌为主,检出率最高的是大肠埃希菌和肺炎克雷伯菌,革兰氏阳性菌以B群链球菌、粪肠球菌为主。大肠埃希菌对喹诺酮类和复方新诺明的耐药率偏高,分别为50.9%和39.6%,对含β-内酰胺酶抑制剂复合制剂及头孢西丁的耐药率较低,均在5.0%以下;肺炎克雷伯菌的整体耐药性不高。B群链球菌对四环素的耐药率高达94.4%,对其他抗生素的耐药性较低。粪肠球菌对奎奴普丁/达福普汀和四环素的耐药率都超过80%,对青霉素类、利奈唑胺、万古霉素很敏感。结论老年女性糖尿病合并尿路感染的临床症状并不典型,临床应积极关注识别;病原菌主要以大肠埃希菌、肺炎克雷伯菌、B群链球菌、粪肠球菌为主,耐药性与病原菌的不同存在差异,未发现多重耐药菌株,临床应根据药敏结果合理诊疗。Objective To investigate the clinical characteristics of urinary tract infection in elderly women with diabetes mellitus,and analyze the distribution of pathogens and their drug resistance.Methods 281 elderly female patients with diabetes mellitus complicated with urinary tract infection were selected as study subjects,and the clinical characteristics,urine culture results and drug sensitivity test of the patients were retrospectively analyzed.Results(1)From clinical manifestations,only 49.5%of enrolled cases had symptoms related to urinary tract infections,and about half of the cases had no typical symptoms;(2)A total of 313 strains of pathogenic bacteria were cultured,with Gram negative bacteria being the main ones.Escherichia coli and Klebsiella pneumoniae had the highest detection rates.Among Gram positive bacteria,Group B Streptococcus and Enterococcus faecalis were the main types.The resistance rates of Escherichia coli to quinolones and compound sulfamethoxazole were relatively high,at 50.9%and 39.6%,respectively.In contrast,the resistance rates toβ-lactamase inhibitor combinations and cefoxitin were relatively low,both below 5.0%;the overall resistance of Klebsiella pneumoniae was not high.Group B Streptococcus had a high resistance rate to tetracycline,reaching 94.4%,while its resistance to other antibiotics was relatively low.Enterococcus faecalis had a resistance rate of over 80%to quinupristin/dalfopristin and tetracycline,but it was highly susceptible to penicillins,linezolid,and vancomycin.Conclusion The clinical symptoms of elderly women with diabetes mellitus complicated with urinary tract infection are not typical,and clinicians should actively pay attention to and identify them;the main pathogens are Escherichia coli,Klebsiella pneumoniae,Group B Streptococcus,and Enterococcus faecalis.The drug resistance varies with different pathogens,and no multidrug-resistant strains are found.Rational diagnosis and treatment based on the results of antimicrobial susceptibility testing should be provided in

关 键 词：糖尿病 老年女性 尿路感染 病原菌 耐药性 

分 类 号：R587.1[医药卫生—内分泌]