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目的探讨糖尿病性肾病患者泌尿系感染的菌群分布及耐药性。方法选取在温岭市第一人民医院就诊的糖尿病性肾病合并泌尿系感染患者共109例,所有患者均收集清洁中段尿进行尿培养及药物敏感试验,分析糖尿病性肾病合并泌尿系感染患者的病原菌分布特点及耐药情况。结果糖尿病性肾病泌尿道感染患者109例共检测出152株病原菌,G~-菌104株,最常见的3种为大肠埃希菌、肺炎克雷伯菌和变形杆菌;G~+菌43株,最常见的3种为金黄色葡萄球菌、肠球菌和表皮葡萄球菌;真菌5株,均为白色念珠菌。主要G~-菌对万古霉素、亚胺培南及阿米卡星的耐药率较低,主要G~+菌对万古霉素、哌拉西林/他唑巴坦、阿莫西林/克拉维酸钾的耐药率较低,真菌对两性霉素B耐药率较低。结论糖尿病性肾病泌尿系感染以G~-菌为主,常规抗生素耐药率高,临床医师应根据耐药性检查及安全性选择合适的抗生素。
Objective To investigate the flora distribution and drug resistance of urinary tract infection in patients with diabetic nephropathy. Methods A total of 109 patients with diabetic nephropathy and urinary tract infection were selected in the First People’s Hospital of Wenling City. All the patients were collected clean urine for urinary culture and drug susceptibility test to analyze the distribution of pathogens in patients with diabetic nephropathy and urinary tract infection Characteristics and drug resistance. Results A total of 152 pathogenic bacteria were detected in 109 patients with diabetic nephropathy and urinary tract infection, 104 of which were G - bacteria. The most common three strains were Escherichia coli, Klebsiella pneumonia and Proteus, and 43 strains of G ~ + bacteria , The most common three kinds of Staphylococcus aureus, Enterococcus and Staphylococcus epidermidis; fungi 5, are Candida albicans. The main G ~ - strains of vancomycin, imipenem and amikacin lower resistance rate, the main G ~ + bacteria against vancomycin, piperacillin / tazobactam, amoxicillin / carat Potassium hyaluronate resistance rate is low, fungal amphotericin B resistance rate is low. CONCLUSION: The urinary tract infection of diabetic nephropathy is mainly G ~ - bacteria, and the conventional antibiotic resistance rate is high. Clinicians should select suitable antibiotics according to drug resistance test and safety.