老年糖尿病患者合并肺部感染76例病原菌及药敏分析

摘要

Objective To evaluate the pathogen distribution of diabetes mellitus complicated with pulmonary infection in the elderly patients and its drug sensitivity test, in order to provide the basis for the clinical medication.Methods We extracted the sputum samples from 76 elderly diabetes mellitus patients complicated with pulmonary infection, and cultured, separated the pathogenic bacteria.Results 53 strains of pathogenic bacteria were detected in 76 patients, in which the gram-negative bacilli accounted for 37.74%, including escherichia coli and klebsiella pneumoniae, sensitive to imipenem and quinolones; The gram-positive bacilli accounted for 30.19%, including staphylococcus epidermidis and staphylococcus aureus, sensitive to vancomycin;The fungal infection accounted for for 32.07%, including candida albicans, sensitive to amphotericin B, lfuconazole and 5- lfucytosine.Conclusion Obviously the elderly diabetic mellitus patients are susceptible to pulmonary infection and mixed infection, with drug resistance enhanced.In order to improve the life quality of diabetes mellitus patients, and decrease the mortality rate, it is extremely important to select sensitive and effective antibiotic therapy according to the characteristics of pathogenic bacteria, in the basis of strict glycemic control.%目的：探讨老年糖尿病患者合并肺部感染的病原菌分布特点和药敏试验情况，以便为临床用药提供依据。方法选取2005年8月～2010年12月武警湖南总队医院收治的老年糖尿病合并肺部感染患者76例的痰标本，培养、分离病原菌。结果76例患者检出53株病原菌，其中革兰阴性菌占37.74%，多为大肠埃希菌、肺炎克雷伯菌杆菌，对亚胺培南、喹诺酮类抗生素敏感；革兰阳性菌占30.19%，多为表皮葡萄球菌和金黄色葡萄球菌，对万古霉素敏感；真菌感染占32.07%，多为白假丝酵母菌，对两性霉素B、氟康唑、5-氟胞嘧啶敏感。结论老年糖尿病患者易罹患肺部感染、混合感染，病原菌耐药性增强，其治疗在严格控制血糖基础上，根据病原菌的特点选择敏感有效的抗生素治疗，有利于病情控制，对提高糖尿病患者的生活质量，降低病死率有着极其重要作用。