老年糖尿病患者尿路感染的病原菌分布及耐药性监测

目的：了解我院老年糖尿病患者尿路感染的病原茵分布及耐药情况，指导临床合理用药。方法：选择我院2010-2012年收治的477例老年糖尿病合并尿路感染患者为研究对象，对其中段尿进行细菌培养及药敏分析。结果：本院老年糖尿病患者尿路感染的细菌以革兰氏阴性菌为主，占67．5％，常见致病菌为大肠埃希菌、肠球菌、肺炎克雷伯茵和表皮葡萄球菌，并发现有2种细菌混合感染及真菌并存感染。革兰阴性菌对亚胺培南、阿米卡星和头孢哌酮／舒巴坦的耐药率较低，而对其他抗菌药物的耐药率较高；革兰阳性茵对万古霉索、阿米卡星和呋喃妥因的耐药率较低，表皮葡萄球菌对万古霉素敏感。结论：本院老年糖尿病患者尿路感染的主要病原菌是大肠埃希菌，其对亚胺培南、阿米卡星和头孢哌酮／舒巴坦的耐药率较低，临床可参考应用。

Distribution of the Pathogens of Elderly Diabetic Patients with Urinary Tract Infection and Antimicrobial Resistance Analysis

Objective： To investigate the distribution of the pathogens of elderly diabetic patients with urinary tract infection, analyze the antimicrobial resistance and guide the reasonable use of antibiotics. Methods： 477 cases of elderly diabetic patients admitted in our hos- pital from 2010 to 2012 were selected, the bacterial culture and susceptibility test were performed for the isolates from mid-stream urine specimen. Results： The urinary tract infection of elderly diabetic patients was mainly caused by Gram-Negative Bacillus, which accounted for 67.5%, the common pathogens were Escherichia coli, Enterococcus, IC pneumoniae, Staphylococcus epidermidis, co-infections of two kinds of pathogens were also observed. The drug resistance rates of Gram-Negative Bacillus to irnipenem, amikacin and cefoperazone/sul- bactam were relatively low, which were relatively high to the other antibiotics. The drug resistance rates of Gram-positive Bacillus to van- comycin, amikacin and macrodantin were relatively low, but staphylococcus epidermidis was sensitive to vancomycin. Conclusion： Es- cherichia coli was the main pathogen of elderly diabetic patients with urinary tract infection, the drug resistance rate of which to imipenem, amikacin and cefolaerazone/sulbactam were relatively low.