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目的:了解近年来糖尿病尿路感染的致病菌分布及药物敏感性情况,为临床合理使用抗菌素提供依据。方法:分析2000—2003年11月住院治疗糖尿病尿路感染患者,其细菌培养结果及细菌对药物敏感性。结果:81例尿培养阳性中,70例为细菌,11例为真菌生长。革兰阴性杆菌占71.6％,其中大肠杆菌占55.56％;革兰阳性菌占14.8％;真菌占13.8％。革兰阴性杆菌对亚胺培南敏感性最高,为82.6％,第三代头孢中头孢他定、头孢噻肟、头孢曲松敏感性65.2—75.86％;噻唑单酰胺菌素敏感性48.28％;喹诺酮类敏感性只有37.93％;氨基糖甙类中庆大霉素、妥布霉素、柰替米星敏感性34.48—37.93％,而丁胺卡那霉素敏感性相对较高为75.86％;磺胺类、青霉素类敏感性在30％以下。革兰阳性菌对万古霉素最敏感,敏感率为90.9％;其次为利福平、呋喃妥因、氯林克霉素,敏感率为72.73％;对青霉素类普遍耐药,敏感率在40％以下。结论:目前糖尿病尿路感染以大肠杆菌感染为主,药物敏感性普遍偏低。临床中耐药菌株的不断增加提醒医生根据药物敏感试验选用对细菌敏感的抗菌素是治疗糖尿病尿路感染的关键。
Objective: To understand the distribution of pathogens in urinary tract infection in recent years and the drug sensitivity, and to provide basis for the rational use of antibiotics in clinic. Methods: Inpatients with diabetic urinary tract infection were hospitalized in 2000-2003 and the results of bacterial culture and drug sensitivity were analyzed. Results: Of the 81 urine culture positives, 70 were bacterial and 11 were fungal growth. Gram-negative bacilli accounted for 71.6%, of which Escherichia coli accounted for 55.56%; Gram-positive bacteria accounted for 14.8%; fungi accounted for 13.8%. Gram-negative bacilli had the highest susceptibility to imipenem, which was 82.6%. The sensitivity of ceftazidime, cefotaxime and ceftriaxone to the third generation cephalosporins was 65.2-75.86%, and the sensitivity to thiazolylmonocarboxamid was 48.28%. The sensitivity of quinolones was only 37.93%. The sensitivity of aminoglycosides to gentamycin, tobramycin and otetmycin was 34.48-37.93%, while the sensitivity of amikacin to amikacin was 75.86%. Sulfonamides, penicillins sensitivity of 30% or less. Gram-positive bacteria were the most sensitive to vancomycin, the sensitivity rate was 90.9%; followed by rifampin, nitrofurantoin, clindamycin, the sensitivity was 72.73%; generally resistant to penicillin, the sensitivity rate of 40% or less . Conclusion: At present, urinary tract infection of diabetes is predominant in Escherichia coli and the drug sensitivity is generally low. Increasing clinical strains of resistant bacteria remind doctors to use antibiotics susceptible to bacteria based on drug susceptibility testing is the key to the treatment of diabetic urinary tract infection.