老年糖尿病并发医院获得性肺内感染52例临床分析

目的探讨老年糖尿病患者并发医院获得性肺内感染的临床特点。方法回顾性分析52例老年糖尿病并发医院获得性肺内感染患者的呼吸系统表现、痰细菌培养及药敏试验结果、治疗及转归。结果52例均有咳嗽、咳痰,37例有发热;51例肺部听诊有罗音;25例X线胸片示单侧出现阴影,肺纹理增粗、紊乱15例。痰细菌培养出21株细菌,其中16株为G-杆菌,对青霉素100%耐药,对头孢他啶敏感率为94%;5株为G 球菌。G-杆菌感染者选用头孢他啶治疗20例,G 球菌感染者选用氧哌嗪青霉素治疗3例。治疗后治愈30例(57%),死亡22例(43%)。结论老年糖尿病并发医院获得性肺内感染患者出现呼吸系统症状和体征;痰细菌培养多培养出G-杆菌,可以选用头孢他啶治疗;此病病死率高。

Elderly Diabetes Mellitus Complicated by Hospital Acquired Pneumonic Infection: A clinical analysis of 52 cases

Objective To investigate the clinical features of elderly diabetes mellitus complicated by hospital acquired pneumonic infection.Methods Retrospective analysis was taken for 52 aged patients with diabetes mellitus complicated by hospital acquired pneumonic infection,including the respiratory manifestations,results of sputum bacterial cultivation with drug sensitivity test,treatment and prognosis.Results All 52 patients had cough and expectoration,37 patients had fever,51 patients had rales on auscultation of lung,25 patients had shadow in one side of the lungs in X-ray film,with increased and disordered lung markings in 15 cases.There were 21 strains of bacteria in sputum cultivation,among which,16 strains were gram-negative bacterium,with resistance rate of 100% against Penicillin and sensitivity rate of 94% to Ceftazidime;5 strains were gram-positive bacterium.For the patients with gram-negative bacterium infection Ceftazidime was given in 20 cases,and for patients with gram-positive bacterium infection Piperacillin was given in 3 cases.After treatment,30 (57%) cases were cured,and 22 (43%) cases died.Conclusion Aged patients with diabetes mellitus complicated by hospital acquired pneumonic infection can have respiratory symptoms and signs.The case of gram-negative bacterium in sputum cultivation is mostly seen,which can be treated with Ceftazidime.The mortality of this disease is high.