糖尿病住院患者下呼吸道感染病原学分析

目的探讨糖尿病患者医院内下呼吸道感染的临床特点及病原学情况。方法回顾性调查69例住院糖尿病患者合并医院内获得性下呼吸道感染的临床资料，分析病原学及细菌耐药性的特点与糖代谢的关系。结果糖尿病患者下呼吸道感染的病原菌以革兰阴性杆菌为主，占73．9％，主要为铜绿假单胞菌18．2％，肺炎克雷伯杆菌15．9％，大肠杆菌14．8％。2种细茼混合感染占14．8％，细菌与真菌并存占6．8％。药物敏感试验提示：革兰阴性杆菌对抗生素敏感性依次为头孢他定72．3％、氧氟沙星70．8％、头孢曲松63．1％、头孢噻肟61．5％、头孢哌酮61．5％、头孢唑啉60．0％、哌拉西林53．8％。革兰阳性球菌对万古霉素100％敏感。对青霉素、红霉素等呈现不同程度的耐药，耐药率在55％以上。血糖控制不好、基础疾病复杂、伴有并发症的糖尿病患者在医院内下呼吸道感染增多。且预后不良。结论糖尿病患者医院内获得性下呼吸遭感染常见，病原菌以革兰阴性杆菌为主，应参考药物敏感试验结果并在控制血糖的基础上进行抗炎治疗。

Hospital- acquired low respiratory tract infection in diabetic patients

Objective To investigate the clinical manifestation and pathogen of hospital- ac- quired low respiratory tract infection in patients with diabetes. Methods To retrospectively analyze the clinical data, and analyze the relationship between pathogen, antibiotic resistance and glucose metabolism. Results Gram - negative bacillus were common in these patients （73.9%）, including Pseudo- monas aeruginosa （ 18.2% ） , Klebsiella pneumoniae （ 15.9% ） , Escherichia （ 14. 8% ） , 14. 8% com- plicated with 2 different bacilli, 6. 8% with 72. 3% to ceftazidime, 70.8% to ofloxacin, fungus. The bacilli sensitive rate to antibiotics was as high as 63.1% to ceftriaxone, 61.5% to cefotaxime, 61.5% to cefoperazone, 60. 0% to cefazolin, 53.8% to piperacillin respectively. Cocci sensitive rate was 100% to vancomycin. Appeared different degree drug resistance to penicillin and erythromycin, the rate is over 55%. Uncontrolled ogenesis of hospital clusions Hospital hyperglycemia, severe basic diseases and diabetic complications involved in the path- acquired low respiratory tract infection were increased and had poor prognosis. Conacquired low respiratory tract infection is common in patients with diabetes, and should make anti - inflammatory treatment based on the antibiotic sensitivity of bacteria and glycemic control