糖尿病合并败血症病原菌和耐药性的分析探讨

目的 探讨糖尿病合并败血症菌种分布特点和耐药谱的变化,指导临床用药.方法 回顾性分析了1999年3月至2004年6月所有血培养阳性且经临床资料证实的18例糖尿病合并败血症.结果 共获阳性血培养株26份.G^＋菌4株;G^-菌17株,居前3位的是克雷伯菌、大肠埃希菌、铜绿假单胞菌;真菌5株,且全为院内感染.G^-菌出现多重耐药且耐药水平增高.结论 G^-菌仍占主流,真菌败血症继续升高,细菌耐药形势严峻,应重视细菌耐药性的动态监测,常规开展产酶菌检测,指导抗生素的合理应用,延缓预防耐药菌株的扩散流行.

An analysis of clinical characteristic and drug resistance of diabetic septicemias

Objective To investigate the trend of the diabetic septicemias inside hospital,and the distribution and drug resistance of the causing bacteria.Method A retrospective analysis was made for 18 cases of septicemias diagnosed by blood cultures and clinical data,which were from March 1999 to June 2004.Results 26 strains of microorganisms were isolated from blood cultures,in which 4 strains were G~+ pathogens positive;17 strains were G~-coccus positive.Among them the first three pathogens were Enterobacter cloacace,Escherichia coli,Pseudomonas aeruginosa;5 strains were fungus septicemia with hospital-acquired.The higher rate and multiple drug resistance was seen in G~-coccus.Conclusions G~-coccus still were major one,and fungus septicemias demonstrated an increasing occurrence trend.The situation of antibiotic resistance was very serious now,so it is important to monitor the bacteria resistance to antibiotics and to detect the strains which can produce enzymes regularly for directing the clinical doctor to use antibiotics reasonably,so as to relieve and prevent the spread of drug resistance strains.