糖尿病并发泌尿系统感染特点与治疗

摘要

Diabetes complicated with urinary tract infection is influenced by many factors, such as low immune function, high blood and urine glucose environment prone for bacterial growth, and nervous lesion.Diabetic urinary tract infections are characterized by insidious onset, high recurrence rate, correlation with high blood glucose and difficulty to control.The related bacterial pathogens are mainly gram-negative bacillus genus ( 58. 59%-76. 19%) , in which the detection rates of extended spectrum β lactamases( ESBLs) Escherichia coli and Klebsiella pneumonia were the highest, followed by Enterobacter cloacae. Gram-positive bacteria only accounted for 23%. Drug-resistant bacteria and fungi would increase under the condition of repeated infection and irrational usage of antibiotics.In recent years, the urine-derived sepsis caused by urinary tract infection had become a popular clinical research topic because of its concealed symptoms, acute onset, rapid development and high mortality. By reviewing domestic and foreign literatures and expert consensus, this article is intended to explore the characteristics and treatment of diabetic urinary tract infections to supply reference for early prevention, correct diagnosis and effective treatments.%糖尿病并发泌尿系统感染受诸多因素的影响，一般而言，糖尿病患者的机体防疫功能减弱，高血糖、高尿糖环境有利于细菌生长繁殖，血管神经病变等因素是导致发生感染的原因。糖尿病并发泌尿系统感染具有起病隐匿、易反复、高血糖的程度与感染呈正相关，并发感染后难以控制等特点。糖尿病并发泌尿系统感染的病原菌以革兰阴性杆菌属为主，占58.59％~76.19％，其中以产超广谱β-内酰胺酶( ESBLs)大肠埃希菌、肺炎克雷白杆菌检出率高，其次是阴沟肠杆菌，革兰阳性菌约占23％。如果反复感染，大量使用抗菌药物可以导致耐药细菌和真菌增加。近年来由尿路感染引起的尿源性脓毒血症，由于隐蔽性强、起病急、发展迅速、病情凶险，病死率高成为临床研究的热点。该文通过复习和综述国内外文献及专家共识，旨在了解糖尿病并发泌尿系统感染的临床特点相关因素，做到早期预防，正确诊断和有效治疗。