老年女性2型糖尿病患者尿路感染病原菌分布及药敏分析

目的 了解老年女性2型糖尿病(T2DM)患者合并尿路感染(UTI)的病原菌分布和药敏率,为临床合理使用抗菌药物提供指导.方法 对2006年8月-2010年7月106例老年女性T2DM患者送检标本进行尿培养病原学鉴定及药敏试验.结果 病原菌中革兰阴性菌占58.5％,以大肠埃希菌为主；革兰阳性菌占33.0％,以肠球菌属为主；真菌占8.5％；大肠埃希菌对氨苄西林、环丙沙星和磺胺甲噁唑/甲氧苄啶的耐药率＞65.0％；肠球菌属对磺胺甲噁唑/甲氧苄啶、红霉素和环丙沙星的耐药率＞ 80.0％,对万古霉素的耐药率达到9.1％.结论 老年女性T2DM患者UTI的病原菌以大肠埃希菌为主,但有下降趋势,肠球菌属和假丝酵母菌属的检出率在上升,病原菌对万古霉素耐药性的增加需高度重视,临床医师应根据药敏结果合理选择抗菌药物.

Distribution and drug susceptibility of pathogenic bacteria causing urinary tract infections in elderly female patients with type 2 diabetics

OBJECTIVE To provide basis for reasonable use of drugs in clinical practice through investigating the characteristics and drug susceptibility of the pathogenic bacteria causing urinary tract infections(UTIs) isolated from elderly female patients with type 2 diabetics(T2DM).METHODS From Aug 2006 to Jul 2010,a total of 106 elderly female patients with T2DM were selected for the identification of etiology of urine culture,the drug susceptibility testing was performed.RESULTS Of the pathogens isolated,gram-negative bacteria accounted for 58.5%,Escherichia coli rated the first;gram-positive bacteria accounted for 33.0%,Enterococcus spp rated the first;fungi accounted for 8.5%;the resistance rates of E.coli to ampicillin,ciprofloxacin and sulfamethoxazole/trimethoprim were higher than 65.0%;the resistance rates of Enterococcus to sulfamethoxazole/trimethoprim,erythromycin and ciprofloxacin were higher than 80.0%,reaching 9.1% to vancomycin.CONCLUSION E.coli is the main pathogen causing UTI in the elderly female patients with T2DM,but the proportion had declined,the detection rates of Enterococcus spp and Candida spp keep an increasingly upward tendency,we should focus on the increasing drug resistance to vancomycin,the clinicians should reasonably select antibiotics on the basis of the results of drug susceptibility testing.