糖尿病合并尿路感染临床特点分析

摘要

目的 分析糖尿病合并尿路感染患者的临床特点.方法 回顾性分析2012年1月至2013年12月就诊于青岛大学附属医院内分泌科的糖尿病合并尿路感染患者的病历资料.结果 1877例糖尿病患者中有198例发生尿路感染,发生率为10.5％.198例患者中老年女性患者121例,占61.1％;94例患者为无症状性菌尿,占47.5％.病原学培养出125株病原菌,其中革兰阴性菌82株(65.6％)(大肠埃希菌最为常见,为58株),革兰阳性菌25株(20.0％),真菌18株(14.4％).35例多重耐药患者中培养出36株多重耐药菌,革兰阴性菌对美罗培南、亚胺培南的敏感性较好(均为100％),对氨苄西林的耐药率较高[大肠埃希菌:77.6％ (45/58),肺炎克雷伯菌:6/6];革兰阳性菌对替加环素、替考拉宁的敏感性较高(均为100％),对莫西沙星、左氧氟沙星、苄星青霉素G、罗红霉素等均存在不同程度的耐药性.结论 糖尿病合并尿路感染患者中老年女性及无症状性菌尿较常见,应根据病原菌种类及药敏结果,合理筛选抗菌药物.%Objective To analyze the clinical characteristics of urinary tract infection in patients with diabete mellitus.Methods Clinical data of diabetes patients complicated with urinary tract infections from January 2012 to December 2013 were retrospectively analyzed.Results Among 1 877 diabetes cases, there were 198 patients (121 elderly female patients) with urinary tract infections, showing an incidence of 10.5％ (61.1％).There were 94 cases with asymptomatic bacteriuria.Bacteriological analysis found 125 strains of pathogensens, including 82 strains (65.6％) of gram-negative bacteria (escherichia coli was the most common, 58 strains), 25 strains (20.0％) of gram-positive bacteria, and 18 strains (14.4％) of fungi.A total of 36 strains of pathogens were cultured from 35 patients with multidrug-resistant bacteria infections.The gram-negative bacteria were sensitive to meropenem and imipenem (sensitivity: 100％) , with high resistance to ampicilin [escheriehia coli: 77.6％ (45/58), klebsialla pneumoniae : 6/6];the gram-positive bacteria were sensitive to tigecycline and teicoplanin, with different degree of resistance to moxifloxacin, levofloxacin and penicillin G.Conclusions In diabetic patients complicated with urinary tract infection, the elderly females are susceptible and the asymptomatic bacteriuria occurs more frequently;it is necessary to use the antibiotics reasonably based on the species of pathogens and the results of drug susceptibility testing.