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目的观察T2DM合并尿路感染病原菌分布特点和药敏结果,并探讨其发生的危险因素。方法分析T2DM合并尿路感染患者的临床特点及病原学特征。结果 T2DM合并尿路感染的发生率为6.85%(210/3065),T2DM合并尿路感染组较T2DM组年龄大、病程长,FPG,尿素氮、肌酐及24h尿白蛋白(24hUAlb)水平高,白蛋白水平低(P<0.05)。Logistic回归分析显示,女性、年龄、糖尿病病程、24hUAlb是发生尿路感染的危险因素,白蛋白为保护因素。分离出的210株病原菌以革兰氏阴性菌为主(84.2%),前3种病原菌为大肠埃希菌(65.2%)、粪肠球菌(6.2%)和肺炎克雷伯菌(5.2%)。革兰氏阴性菌对亚胺培南(100%)、头孢哌酮舒巴坦(99.2%)和阿米卡星(99.2%)敏感性较高,对头孢噻吩(38.1%)、哌拉西林(35.7%)和阿莫西林(28.2%)敏感性较低。结论老年、女性、糖尿病病程长及肾功能不全的T2DM患者更易发生尿路感染,T2DM合并尿路感染的病原菌仍以革兰氏阴性菌为主,但细菌谱发生了一定的变化,且多重耐药菌呈明显上升趋势。
Objective To observe the distribution characteristics and drug susceptibility of pathogenic bacteria in T2DM complicated with urinary tract infection and to explore the risk factors for their occurrence. Methods The clinical features and etiological characteristics of T2DM patients with urinary tract infection were analyzed. Results The incidence of T2DM complicated with urinary tract infection was 6.85% (210/3065). T2DM complicated with urinary tract infection was older than T2DM with long course of disease, with high levels of FPG, urea nitrogen, creatinine and 24 h urinary albumin (24hUAlb) Albumin levels were low (P <0.05). Logistic regression analysis showed that women, age, duration of diabetes, 24hUAlb were the risk factors of urinary tract infection, and albumin was the protective factor. Of the 210 isolates, Gram-negative bacteria were predominant (84.2%), the first three pathogens were Escherichia coli (65.2%), Enterococcus faecalis (6.2%) and Klebsiella pneumoniae (5.2%), . Gram-negative bacteria were more sensitive to imipenem (100%), cefoperazone-sulbactam (99.2%) and amikacin (99.2%). Cefotaxime (38.1%), piperacillin (35.7%) and amoxicillin (28.2%) were less sensitive. Conclusions Urinary tract infection is more likely to occur in T2DM patients with long history of diabetes mellitus and renal insufficiency. The pathogens of T2DM with urinary tract infection are still mainly Gram-negative bacteria, but the spectrum of bacteria has some changes, and multiple resistance Bacteria showed a clear upward trend.