摘要
目的分析2型糖尿病合并血流感染患者病原学分布及药敏特征,为临床合理选用抗菌药物提供依据。方法回顾性分析2013年1月-2017年12月江苏大学附属武进医院收治的2型糖尿病合并血流感染患者113例的临床资料、病原菌分布及耐药情况。结果血培养共分离出病原菌113株,其中革兰阴性菌79株(69.91%),革兰阳性菌32株(28.32%),真菌2株(1.77%)。革兰阴性菌以大肠埃希菌(51株)、肺炎克雷伯菌(20株)为主,其中ESBLs阳性大肠埃希菌检出率为54.90%(28/51),产ESBLs肺炎克雷伯菌检出率为15.00%(3/20)。感染部位以泌尿系统最多(44例),其次为呼吸系统(20例)、消化系统(18例)。大肠埃希菌和肺炎克雷伯菌对亚胺培南、美罗培南、阿米卡星、哌拉西林他唑巴坦耐药率低。主要革兰阳性球菌对青霉素、苯唑西林耐药率高,对万古霉素、利奈唑胺100.00%敏感。结论2型糖尿病合并血流感染的病原菌以革兰阴性菌多见,主要为大肠埃希菌及肺炎克雷伯菌感染,感染部位以泌尿道及呼吸道感染多见,定期分析病原菌分布及药敏情况,有助于指导临床合理用药。
Objective To study the distribution and drug resistance of pathogenic bacteria in patients with type 2 diabetes(T2DM)complicated with bloodstream infection and provide basis for the rational selection of antibacterial drugs in clinic.Methods The clinical data,pathogenic bacteria distribution and drug resistance of 113 patients with T2DM complicated with bloodstream infection admitted to Wujin Hospital Affiliated to Jiangsu University from January 2013 to December 2017 were analyzed retrospectively.Results A total of 113 pathogens were isolated from blood culture of patients,among which there were 79 strains(69.91%)of gram-negative bacteria,32 strains(28.32%)of gram-positive bacteria,and 2 strains(1.77%)of fungi.Gram-negative bacteria were mainly Escherichia coli(51 strains)and Klebsiella pneumoniae(20 strains).The detection rate of ESBLs-positive Escherichia coli was 54.90%(28/51),the detection rate of ESBLs-producing Klebsiella pneumoniae was 15.00%(3/20).The urinary system infection was the most common infection sites(44 cases),followed by the respiratory(20 cases)and digestive system infections(18 cases).Escherichia coli and Klebsiella pneumoniae were susceptible to imipenem,meropenem,amikacin and piperacillin/tazobactam;most of gram-positive bacteria were highly resistant to penicillin and oxacillin,while 100.00%sensitive to vancomycin and linezolid.Conclusion Gram-negative bacteria was the main pathogens in patients with T2DM complicated with bloodstream infections,mainly caused by Escherichia coli and Klebsiella pneumoniae,urinary and respiratory infections are the most common infection site,regular analysis of pathogen distribution and bacteria resistance is helpful to guide the rational use of drugs in clinic.
作者
薛一
薛冰霜
邵雪景
XUE Yi;XUE Bingshuang;SHAO Xuejing(Department of Endocrinology,Wujin Hospital Affiliated to Jiangsu University,Jiangsu Province,Changzhou 213017,China;Wujin Clinical College of Xuzhou Medical University,Jiangsu Province,Changzhou 213017,China)
出处
《临床合理用药杂志》
2021年第22期10-12,16,共4页
Chinese Journal of Clinical Rational Drug Use
基金
江苏大学临床医学科技发展基金项目(No:JLY20180083)
常州市青年人才科技项目(No:QN201828)
常州市武进区科技项目(No:WS201806)。
关键词
糖尿病
2型
血流感染
病原菌
耐药性
Diabetes,type 2
Bloodstream infection
Pathogen
Drug resistance
