發(fā)布時間：2018-06-28 06:27

  本文選題：泌尿系統感染 + 糖尿病　； 參考：《中華醫(yī)院感染學雜志》2017年06期

【摘要】：目的探討醫(yī)院健康體檢糖尿病患者泌尿系統感染情況,為糖尿病患者泌尿系統感染預防和治療提供依據。方法篩選2013年1月-2016年3月在醫(yī)院符合條件的糖尿病患者538例為研究對象,分析糖尿病患者泌尿系統感染率和病原菌分部情況。結果 538例糖尿病患者中共有58例病原菌培養(yǎng)陽性,感染率為10.78%;58例泌尿系統感染患者共分離出62株病原菌;其中革蘭陰性桿菌37株,占59.68%,革蘭陽性球菌21株,占33.87%,真菌4株,占6.45%;革蘭陰性菌大腸埃希菌對氨芐西林、頭孢他啶、頭孢呋辛等的耐藥率均在65%以上;肺炎克雷伯桿菌對氨芐西林、頭孢呋辛、哌拉西林、頭孢噻肟的耐藥率均在65%以上;奇異變形桿菌對氨芐西林、頭孢他啶、哌拉西林、頭孢噻肟的耐藥率均在65%以上;大腸埃希菌、肺炎克雷伯桿菌、奇異變形桿菌對亞胺培南100%敏感,對頭孢哌酮/舒巴坦的耐藥性均不高于25%;革蘭陽性菌中糞腸球菌、金黃色葡萄球菌、凝固酶陰性葡萄球菌對青霉素和紅霉素的耐藥率均在70%以上,但都對萬古霉素100%敏感;白假絲酵母菌對氟康唑、兩性霉素B、制霉菌素、伊曲康唑、酮康唑均較敏感。結論糖尿病患者易發(fā)生泌尿系統感染,且病原菌對抗菌藥物耐藥性較為嚴重,臨床應根據藥敏試驗選擇合適的抗菌藥進行感染治療。
[Abstract]:Objective to investigate the urinary system infection of diabetic patients in hospital health examination, and to provide evidence for the prevention and treatment of urinary tract infection in diabetic patients. Methods 538 patients with diabetes mellitus were selected from January 2013 to March 2016. The infection rate of urinary system and the distribution of pathogenic bacteria in diabetic patients were analyzed. Results of the 538 patients with diabetes mellitus, 58 cases were positive for pathogen culture, and the infection rate was 10.78%. A total of 62 strains of pathogenic bacteria were isolated from 58 patients with urinary system infection, among which 37 strains of Gram-negative bacilli (59.68%), 21 strains of Gram-positive cocci (33.87%) and 4 strains of fungi. The resistance rates of Escherichia coli to ampicillin, ceftazidime and cefuroxime were over 65%, and the resistance rates of Klebsiella pneumoniae to ampicillin, cefuroxime, piperacillin and cefotaxime were over 65%. The resistance rates of Proteus mirabilis to ampicillin, ceftazidime, piperacillin and cefotaxime were over 65%, and Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were sensitive to imipenem 100%. The drug resistance of Enterococcus faecalis, Staphylococcus aureus and coagulase-negative staphylococcus to penicillin and erythromycin in Gram-positive bacteria were over 70%, but sensitive to vancomycin 100%. Candida albicans were sensitive to fluconazole, amphotericin B, nystatin, itraconazole and ketoconazole. Conclusion Diabetes mellitus patients are prone to urinary tract infection and the pathogens are more resistant to antimicrobial agents. The appropriate antibiotics should be selected according to the drug sensitivity test.
【作者單位】： 臺州市立醫(yī)院體檢中心;
【基金】：浙江省醫(yī)藥科技計劃基金資助項目(20157283)
【分類號】：R587.2;R691.3

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