老年糖尿病患者泌尿道感染病原菌培养及耐药性的分析

目的探讨老年糖尿病(DM)患者泌尿道感染病原菌的种类及耐药性,为医师选择合适的抗菌药物提供参考依据。方法统计该院2014年1~12月老年DM患者1 689例尿培养及药敏结果。尿液定量培养、病原菌的鉴定和药敏检测依据临床微生物学检验技术规范和KB法进行操作。结果 703株尿培养阳性菌中,大肠埃希菌占61.9%,肺炎克雷伯菌占12.5%,肠球菌属占8.1%,分别居第1、2、3位;超广谱β-内酰胺酶(ESBLs)检出率48.6%,耐甲氧西林葡萄球菌(MRS)检出率51.5%;革兰阴性菌对磺胺甲噁唑/甲氧苄啶耐药率最高,均大于60.0%,耐药率小于25.0%的药物有阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南。结论老年DM患者泌尿道病原菌的耐药性因种类而各不相同,医师务必参照病原学和药敏报告,选择合适的药物控制感染。

Pathogenic bacteria culture and drug resistance analysis in urinary tract infections in senile diabetics

Objective To approach species and drug‐resistance of pathogenic bacteria in urinary tract infections in senile patients with diabetes mellitus(DM ) and offer evidence for reasonable use of antibiotics .Methods The urine culture and sensitivity results were analyzed statistically for 1 689 cases of aged diabetic patients with urinary tract infection in their hospital in 2014 .Quantitative urine culture ,pathogenic identification and susceptibility testing were carried out according to clinical microbiological examination technology and KB method .Results Among 703 strains of pathogenic bacteria ,Escherichia coli ,K .peneumoniae and Enterococcus faecalis ,ranking the first ,second and third , accounted for 61 .9% ,12 .5% and 8 .1% ,respectively .The total detection rate of ESBLs‐producing strains was 48 .6% .That of meticillin‐resistant staphylococci(MRS)was 51 .5% .Resistance rate of sulfamethoxazole/trime‐thoprim against gram‐negative bacteria was the highest and more than 60 .0% .Antibiotics with resistance rate of less than 25 .0% included amikacin ,cefoperazone/sulbactam ,piperacillin/tazobactam ,imipenem and meropenem .Conclu‐sion Drug‐resistance of pathogenic bacteria varied from bacterial specie to specie in senile diabetics .It was recom‐mended that the clinician should choose the suitable drug for anti‐infective therapy based on etiological detection and drug susceptibility test results .