摘要
目的分析糖尿病泌尿系统感染患者多重耐药菌感染的病原菌分布及耐药性,为临床合理用药提供参考依据。方法选择2014年2月至2016年2月于本院接受治疗的糖尿病伴泌尿系统多重耐药菌感染患者121例为研究对象。留取所有患者的中段尿液行细菌培养,并行病种分离和药敏试验。结果 121例糖尿病患者共培养出致病菌155株,其中革兰阳性菌60株,革兰阴性菌78株,真菌17株。对大肠埃希菌耐药性强弱顺序为阿莫西林、头孢唑林、复方新诺明、头孢噻肟、头孢曲松,敏感性最强的为美罗培南,其次为左氧氟沙星、头孢哌酮舒巴坦、头孢西丁、环丙沙星;对肺炎克雷伯菌耐药性强弱顺序为阿莫西林、头孢噻肟、头孢唑林、复方新诺明、头孢曲松,敏感性最强的为头孢哌酮舒巴坦、美罗培南、阿米卡星;对鲍曼不动杆菌耐药性强弱顺序为头孢西丁、头孢曲松、头孢吡肟、头孢唑林,敏感性最强的为美罗培南、左氧氟沙星、哌拉西林他唑巴坦、阿米卡星。对表皮葡萄球菌耐药性强弱顺序为青霉素、磺胺甲恶唑、罗红霉素,敏感性最强的为替考拉宁、万古霉素、呋喃妥因、利奈唑胺、米诺环素;对屎肠球菌耐药性强弱顺序为青霉素、克林霉素、头孢唑林,敏感性最强的为万古霉素、氧氟沙星、替考拉宁、利奈唑胺。近平滑假丝酵母菌对氟胞嘧啶无耐药性,白色假丝酵母菌对双性霉素B、氟胞嘧啶以及伊曲康唑均无耐药性。结论糖尿病患者泌尿系统感染以革兰阴性菌为主,其对较多常用药物均具有较强耐药性,应根据药敏试验结果合理选择抗菌药物。
Objective To investigate the distribution of pathogenic bacteria and drug resistance of multidrug-resistant bacteria in patients with diabetic urinary system infection and provide reference for clinical rational use of drugs. Method From February 2014 to February 2016, 121 patients with diabetes mellitus with multiple drug resistance in the urinary system were treated in our hospital. The middle urine of all patients were left for bacterial culture, and the disease isolation and drug sensitivity test were carried out. Result 121 cases of diabetic patients were cultured 155 strains of pathogenic bacteria, 60 strains of Gram positive bacteria, 78 strains of Gram negative bacteria, 17 strains of fungi. Escherichia coli had strong resistance to Amoxicillin, Cefazolin, Paediatric compound sulfamethoxazole, Cotrimoxazole, Cefotaxime, Cefatriaxone, and had strong sensitivity to Meropenem, followed by Levofloxacin, Cefperazone-Sulbactam, Cefoxitin, Ciprofloxacin. Klebsiella pneumoniae had strong resistance to Amoxicillin, Cotrimoxazole, Cefazolin, Paediatric compound sulfamethoxazole, Cefatriaxone, and had strong sensitivity to Cefperazone-Sulbactam, Meropenem, Amikacin. Acinetobacter baumannii had strong resistance to Cefoxitin, Cefatriaxone, Cefepime, Cefazolin, and had strong sensitivity to Meropenem, Levofloxacin, Piperacillin and tazobactam, Amikacin. Staphylococcus epidermidis had strong resistance to Penicillin, Sulfamethoxazole, Roxithromycin, and had strong sensitivity to Teicoplanin, Vancomycin, Nitrofurantoin, Linezolid, Minocycline, Enterococcus faecium had strong resistance to Penicillin, Clindamycin, Cefazolin, and had strong sensitivity to Levofloxacin, Vancomycin, Teicoplanin and Linezolid. Candida albicans had no resistance to Flurocytosine, and Candida albicans had no resistance to Amphotericin B, Flurocytosine and Itraconazole. Conclusion Diabetic patients with urinary system infection is mainly for Gram-negative bacteria, which has a strong resistance to many commonly used drugs, we should be actively based on drug sensitivity results to select the appropriate drug treatment.
出处
《中国医学前沿杂志（电子版）》
2017年第10期141-144,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
四川省卫生厅课题项目(120395)
关键词
糖尿病
泌尿系统感染
耐药菌
Diabetes
Urinary tract infections
Multi drug resistant bacteria
