女性糖尿病患者合并尿路感染大肠埃希菌耐药性分析

目的 回顾性分析女性糖尿病(DM)合并尿路感染( UTI)大肠埃希菌的耐药情况及产超广谱β-内酰胺酶(ESBLs)的发生率,以指导临床合理选择抗菌药物.方法 对近4年在浙江大学医学院附属第二医院确诊DM合并UTI女性患者的中段尿标本中分离出的95株大肠埃希菌进行耐药性分析,用纸片扩散法表型确证试验检测ESBLs,以女性非糖尿病患者为对照组,并以年份进行分组分析.结果 95株大肠埃希菌ESBLs阳性率为40.0％,明显高于对照组,糖尿病组对氨苄西林、环丙沙星、左氧氟沙星耐药率较高,均＞60.0％,对环丙沙星、左氧氟沙星、头孢曲松、头孢唑林、头孢吡肟、头孢呋辛耐药率明显高于对照组,早期组与近期组的产ESBLs率及耐药率差异无统计学意义.结论 女性糖尿病伴尿路感染大肠埃希菌对多种抗菌药物的耐药率较高,临床应根据药敏试验结果合理使用抗菌药物.

Analysis of drug resistance of Escherichia coli in female patients of diabetes mellitus complicated with urinary tract infection

Objective To analyze retrospectively the drug resistance of Escherichia coli and the detection rate of extended spectrum β-lactamase （ESBLs） in female patients with diabetes mellitus （DM） and urinary tract infection （UTI） for guiding rational choice of antibiotics. Methods Drug resistances of 95 Escherichia coli strains collected from the female patients with DM and UTI in recent 4 years were analyzed. And the extended spectrum β-lactamase （ESBLs） were identified by disc agar diffusion method. Non-DM female patients were used as the control. Analysis was performed in groups divided by years. Results The detection rate of ESBLs-producing Escherichia coli was 40.0%, which was obviously higher than the con- trol group. The drug resistance rates of the DM group to Ampicillin, Ciprofloxacin and Levofloxacin were all higher than 60%, while those to Ciprofloxacin, Levofloxacin, Ceftriaxone, Cefazolin, Cefepime and Cefuroxime were all obviously higher than the control group. Both the ESBLs production rate and drug resistance rate had no significant difference between the two DM groups. Conclusion Female patients with DM and UTI infected by Escherichia coli had high drug resistance ratio to multiple antibiotics. Antibiotics should be used rationally according to drug sensitivity test.