摘要
目的探讨妊娠合并糖尿病(GMD)并发产褥期感染临床特征、病原菌特点及耐药性。方法回顾性选取2020年1月-2022年12月南宁市妇幼保健院收治的154例GMD并发产褥期感染患者为研究组,同期160例非糖尿病产褥期感染患者为对照组。比较不同感染部位病原菌分布情况;比较两组产褥期感染病原菌分布及耐药性情况。结果两组临床特征及病原菌感染部位比较,均无统计学差异。314例产褥期感染患者共分离出病原菌322株,两组革兰阳性菌、真菌比较,无统计学差异,而研究组革兰阴性菌较对照组多,且研究组大肠埃希菌较对照组多(P<0.05)。两组产褥期感染的金黄色葡萄球菌对头孢拉定、青霉素、氨西林的耐药性均50%,研究组金黄色葡萄球菌对头孢噻的耐药性较对照组高(P<0.05);表皮葡萄球菌对左氧氟沙星的耐药性>50%,两组产褥期感染的大肠埃希菌对青霉素、头孢他啶、诺氟沙星、左氧氟沙星、阿米卡星、哌拉西林的耐药性均50%。结论GMD患者并发产褥期感染与患者一般资料以及病原菌感染部位等因素无关,GMD可影响产褥期感染患者病原菌特点及耐药性,可增加革兰阴性菌感染率,也可提高金黄色葡萄球菌耐药性。
OBJECTIVE To explore the clinical characteristics of gestational diabetes mellitus(GDM)patients com-plicated with puerperal infection,distribution of pathogens and drug resistance.METHODS A total of 154 GDM patients complicated with puerperal infection who were treated in Nanning Maternal and Child Hospital from Jan 2020 to Dec 2022 were chosen as the study group,meanwhile,160 non-GDM patients with puerperal infection were chosen as the control group.The distribution of pathogens causing different sites of infections was compared.The distribution and drug resistance of the pathogens causing the puerperal infection were observed and compared between the two groups.RESULTS There were no significant differences in the clinical characteristics and infection sites between the two groups.Totally 322 strains of pathogens were isolated from the 314 patients with puerperal infection.There were no significant differences in the gram-positive bacteria and fungi between the two groups.The gram-negative bacteria of the study group were significantly more than those of the control group,and the Escherichia coli strains of the study group were significantly more than those of the control group(P<0.05).The drug resistance rates of Staphylococcus aureus strains to cefradine,penicillin and ampicillin were more than 50%in the two groups;the drug resistance rate of the S.aureus strains to cefotaxime was significantly higher in the study group than in the control group(P<o.05).The drug resistance rate of the Staphylococus epidermidis strains to levofloxacin was more than 5o%.The drug resistance rates of E.coli strains to penicillin,ceftazidime,norfloxacin,levofloxacin,amikacin and piperacillin were more than 50%in the two group.CONCLUSION The puerperal infection of the GMD patients is not associated with the factors such as baseline data and infection sites.The GDM may affect the characteristics of pathogens and drug resistance of the patients with puerperal infection and increase the incidence of gram-negative bacteria infections and the drug resistance to S.aureus.
作者
张云燕
卢冠名
周艳春
王宗杰
ZHANG Yun-yan;LU Guan-ming;ZHOU Yan-chun;WANG Zong-jie(Nanning Maternal and Child Health Hospital,Nanning,Guangri 53001l,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第13期2037-2040,共4页
Chinese Journal of Nosocomiology
基金
广西壮族自治区卫健委科研基金资助项目(Z-A20221248)。
关键词
妊娠合并糖尿病
产褥期感染
流行病学
病原菌
耐药性
金黄色葡萄球菌
表皮葡萄球菌
大肠埃希菌
Gestational diabetes mellitus
Puerperal infection
Epidemiology
Pathogen
Drug resistance
Staph-ylococcus aureus
Staphylococcus epidermidis
Escherichia coli
作者简介
张云燕(1968-),女,硕士,主任医师,研究方向:妊娠内分泌、产科重症。
