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目的调查糖尿病患者发生医院感染部位、病原菌分布及其耐药性,为临床预防治疗提供基础。方法选取医院普外科2010年12月-2013年11月因需手术收治的235例2型糖尿病医院感染患者为研究对象,调查分析入选患者临床资料,统计感染部位分布、病原菌种类及其对常规抗菌药物的耐药性,采用Microsoft Excel 2007版软件对数据进行分析。结果 235例医院感染患者中呼吸道感染占40.0%、泌尿道感染占21.3%、消化道感染占19.1%、皮肤及软组织感染占12.8%、血液感染占6.8%;共分离鉴定256株病原菌,革兰阴性菌占50.4%、革兰阳性菌占35.2%和真菌占14.4%;革兰阴性菌对多数常用抗菌药物具有较高耐药性,对头孢哌酮/舒巴坦耐药率较低,为9.8%~16.7%;对美罗培南和亚胺培南耐药率为0~4.2%;革兰阳性菌对克林霉素、万古霉素、莫西沙星和呋喃妥因耐药率较低,为10.0%~31.0%;对替考拉宁和利奈唑胺耐药率均为0。结论糖尿病合并医院感染患者感染部位以呼吸道感染为主,病原菌以革兰阴性菌为主,其对大多数常用抗菌药物有较高的耐药率,临床应参考药敏试验结果,合理选用抗菌药物。
Objective To investigate the distribution of nosocomial infection sites and pathogenic bacteria in patients with diabetes mellitus and their drug resistance and provide the basis for clinical prevention and treatment. Methods A total of 235 cases of type 2 diabetic nosocomial infections admitted to our hospital from December 2010 to November 2013 were enrolled in this study. The clinical data of selected patients were analyzed and statistically analyzed. The distribution of pathogens, Drug resistance, using Microsoft Excel 2007 version of the software for data analysis. Results Among 235 cases of hospital infection, respiratory infections accounted for 40.0%, urinary tract infections accounted for 21.3%, gastrointestinal infections accounted for 19.1%, skin and soft tissue infections accounted for 12.8%, blood infections accounted for 6.8%; 256 strains were isolated and identified Gram Gram-negative bacteria accounted for 50.4%, Gram-positive bacteria accounted for 35.2% and fungi accounted for 14.4%; Gram-negative bacteria for most commonly used antibacterial drugs have a higher resistance to cefoperazone / sulbactam resistance was low, as 9.8% ~ 16.7%. The rates of resistance to meropenem and imipenem were 0 ~ 4.2%. The resistance rates of gram-positive bacteria to clindamycin, vancomycin, moxifloxacin and nitrofurantoin were lower % ~ 31.0%. The rates of resistance to teicoplanin and linezolid were both 0. Conclusions Infection in patients with diabetes mellitus and nosocomial infections is mainly respiratory tract infection. Gram-negative bacteria are the main pathogenic bacteria in the patients with diabetes mellitus, which has a high resistance rate to most commonly used antibiotics. The clinical results should be based on the results of drug susceptibility testing, and rational use of antimicrobial agents .