摘要
目的探讨老年糖尿病患者尿路感染病原菌的分布及耐药性,为临床治疗合理选择抗生素提供参考依据。方法回顾性分析湖北省中医院2014~2016年患尿路感染的老年糖尿病患者的尿培养及药敏结果。结果 331株尿培养阳性菌中,居于前3位的分别是大肠埃希菌(194株,58.6%)、粪肠球菌(30株,9.1%)和铜绿假单胞菌(27株,8.2%),其中,产ELBLs大肠埃希菌占大肠埃希菌的55.2%(107/194),产ELBLs的肺炎克雷伯菌占肺炎克雷伯菌的66.7%(16/24)。革兰阴性杆菌普遍对阿米卡星和亚胺培南高度敏感,但是对氨苄西林/舒巴坦、左氧氟沙星、环丙沙星和头孢曲松的耐药率均大于50%;革兰阳性球菌中粪肠球菌和屎肠球菌对克林霉素、高浓度庆大霉素和高浓度链霉素的耐药率大于50%,而对万古霉素和利奈唑胺高度敏感。结论老年糖尿病患者尿路感染病原菌以大肠埃希菌和肠球菌属为主,对常用抗生素耐药率高,临床医师应引起高度重视,根据尿培养及药敏试验,合理选用抗菌药物。
Objective To discuss the pathogen distribution and drug resistance of urinary tract infection in senile diabetics, in order to offer evidence for reasonable use of antibiotics. Methods The urine culture and drug sensitivity results were analyzed among senile diabetics with urinary tract infection from 2014 to 2016 in Hubei Provincial Hospital of Traditional Chinese Medicine. Results Among the 331 strains of pathogenic bacteria, the first three were Escherichia coli（194 strains, 58.6%）, Enterococcus faecalis（30 strains, 9.1%） and Pseudomonas aeruginosa（27 strains, 8.2%）. The detection rate of ESBLS-producing strains was 55.2%（107/194） of Escherichia coli, which of Klebsiella pneumoniae was 66.7%（16/24）. Resistant rate of Gram-negative bacteria on Amikacin and Imipenem was low, but the rates of that on Ampicillin/Sulbatam, Levofloxacin, Ciprofloxacin and Ceftriaxone were all greater than 50%. The resistant rate of Enterococcus faecalis and Enterococcus faecium were greater than 50% to Clindamycin, high concentration Gentamycin and high concentration Streptomycin, but were highly sensitive to Vancomycin and Linezolid. Conclusion Urinary tract infection in senile diabetics is mainly caused by Escherichia coli and Enterococcus, which are highly resistant to routine antibiotics. Clinicians should attach great importance to drug sensitivity results and select antibiotics according to the result of urine culture and drug sensitive test.
作者
韩竖霞
倪维
HAN Shuxia ,NI Wei(Department of Clinical Laboratory, Hubei Province Academy of Traditional Chinese Medicine tal of Traditional Chinese Medicine, Hubei Province, Wuhan 430061, Chin)
出处
《中国医药导报》
CAS
2018年第10期55-57,71,共4页
China Medical Herald
基金
国家自然科学基金资助项目(81573815)
关键词
糖尿病
尿路感染
病原菌
耐药性
Diabetes
Urinary tract infection
Pathogenic bacteria
Drug-resistance
