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目的:了解我院老年糖尿病患者尿路感染的病原菌分布及耐药情况,指导临床合理用药。方法:选择我院2010~2012年收治的477例老年糖尿病合并尿路感染患者为研究对象,对其中段尿进行细菌培养及药敏分析。结果:本院老年糖尿病患者尿路感染的细菌以革兰氏阴性菌为主,占67.5%,常见致病菌为大肠埃希菌、肠球菌、肺炎克雷伯菌和表皮葡萄球菌,并发现有2种细菌混合感染及真菌并存感染。革兰阴性菌对亚胺培南、阿米卡星和头孢哌酮/舒巴坦的耐药率较低,而对其他抗菌药物的耐药率较高;革兰阳性菌对万古霉素、阿米卡星和呋喃妥因的耐药率较低,表皮葡萄球菌对万古霉素敏感。结论:本院老年糖尿病患者尿路感染的主要病原菌是大肠埃希菌,其对亚胺培南、阿米卡星和头孢哌酮/舒巴坦的耐药率较低,临床可参考应用。
Objective: To understand the distribution of elderly patients with urinary tract infection in urinary tract pathogens and drug resistance, and guide clinical rational use of drugs. Methods: A total of 477 elderly patients with diabetes mellitus and urinary tract infection admitted to our hospital from 2010 to 2012 were enrolled in this study. Bacterial culture and drug susceptibility analysis were performed on the urine of the middle stage. Results: Urinary tract infections in elderly patients with diabetes mellitus were mainly Gram-negative bacteria, accounting for 67.5%. Common pathogenic bacteria were Escherichia coli, Enterococcus, Klebsiella pneumoniae and Staphylococcus epidermidis. There are two kinds of bacteria mixed infection and fungal infection. Gram-negative bacteria to imipenem, amikacin and cefoperazone / sulbactam resistance rate is low, while the resistance rate of other antibacterials higher; gram-positive bacteria on vancomycin, Amikacin and nitrofurantoin resistance rate is low, Staphylococcus epidermidis susceptible to vancomycin. Conclusion: The main pathogen of urinary tract infection in elderly diabetic patients in our hospital is Escherichia coli. The drug resistance rate to imipenem, amikacin and cefoperazone / sulbactam is low, so it can be used clinically for reference.