老年2型糖尿病合并败血症患者病原菌分布及药物敏感性分析
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摘要
目的探讨老年2型糖尿病合并败血症患者的病原菌种类及其对抗菌药物的敏感性。方法回顾性分析55例老年2型糖尿病合并败血症患者的临床资料,总结其病原菌分布及其药物敏感性。结果 55例患者中共检测到55株病原菌,其中革兰阴性菌31株(56. 4%),革兰阳性菌22株(40. 0%),真菌2株(3. 6%)。革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌以葡萄球菌属为主,其中以耳葡萄球菌、金黄色葡萄球菌多见。院内感染和社区感染常见病原菌均为大肠埃希菌、肺炎克雷伯菌。常见革兰阴性病原菌对头孢唑林、氨苄西林、头孢呋辛、头孢曲松、复方新诺明的耐药性较高;常见革兰阳性菌对青霉素、红霉素、克拉霉素、阿奇霉素、四环素的耐药性较高。结论老年2型糖尿病并发败血症患者多为革兰阴性菌感染,以大肠埃希菌和肺炎克雷伯菌感染为主,应定期分析病原菌分布变化及其药物敏感性,以指导临床合理用药。
Objective To investigate the species and antibiotics susceptibility of pathogens in elderly type 2 diabetes mellitus patients complicated with septicemia. Methods The clinical data of 55 elderly type 2 diabetes mellitus patients complicated with septicemia were retrospectively analyzed,their pathogen distribution and drug susceptibility were summarized. Results Among 55 strains of pathogenic bacteria detected in the 55 patients,31( 56. 4%) were gram-negative bacteria,22( 40. 0%) were gram-positive bacteria,and 2( 3. 6%) were fungus. Gram-negative bacteria were dominated by Escherichia coli and Klebsiella pneumoniae; most of gram-positive bacteria were Staphylococcus,in which Staphylococcus auricularis and Staphylococcus aureus were commonly observed. The major pathogens of nosocomial and community infections were Escherichia coli and Klebsiella pneumoniae. The drug resistance of common gram-negative bacteria to cefazolin,ampicillin,cefuroxime,ceftriaxone,or trimethoprim-sulfamethoxazole was higher; the drug resistance of common gram-positive bacteria to penicillin,erythromycin,clarithromycin,azithromycin,or tetracycline was higher.Conclusion Most of elderly patients with type 2 diabetes mellitus complicated with septicemia suffer from gram-negative bacterial infection,mainly caused by Escherichia coli or Klebsiella pneumoniae. It is necessary to carry out regular analysis of changes in pathogen distribution and their drug susceptibility so as to provide guidance for rational drug use in clinical practice.
Objective To investigate the species and antibiotics susceptibility of pathogens in elderly type 2 diabetes mellitus patients complicated with septicemia. Methods The clinical data of 55 elderly type 2 diabetes mellitus patients complicated with septicemia were retrospectively analyzed,their pathogen distribution and drug susceptibility were summarized. Results Among 55 strains of pathogenic bacteria detected in the 55 patients,31( 56. 4%) were gram-negative bacteria,22( 40. 0%) were gram-positive bacteria,and 2( 3. 6%) were fungus. Gram-negative bacteria were dominated by Escherichia coli and Klebsiella pneumoniae; most of gram-positive bacteria were Staphylococcus,in which Staphylococcus auricularis and Staphylococcus aureus were commonly observed. The major pathogens of nosocomial and community infections were Escherichia coli and Klebsiella pneumoniae. The drug resistance of common gram-negative bacteria to cefazolin,ampicillin,cefuroxime,ceftriaxone,or trimethoprim-sulfamethoxazole was higher; the drug resistance of common gram-positive bacteria to penicillin,erythromycin,clarithromycin,azithromycin,or tetracycline was higher.Conclusion Most of elderly patients with type 2 diabetes mellitus complicated with septicemia suffer from gram-negative bacterial infection,mainly caused by Escherichia coli or Klebsiella pneumoniae. It is necessary to carry out regular analysis of changes in pathogen distribution and their drug susceptibility so as to provide guidance for rational drug use in clinical practice.
引文
[1]廖二元,莫朝晖.内分泌学[M]. 2版.北京:人民卫生出版社,2007:1 537-1 541.
[2] Magliano DJ,Harding JL,Cohen K,et al. Excess risk of dying from infectious causes in those with type 1 and type 2diabetes[J]. Diabetes Care,2015,38(7):1 274-1 280.
[3]王冬梅.对31例老年败血症患者的临床分析[J].求医问药(学术版),2011,9(9):248-248.
[4]刘梅,张军学,张文娟,等. 35例老年患者医院感染败血症临床分析[J].中华医院感染学杂志,2010,20(22):3 478-3 479.
[5] Alberti KG,Zimmet PZ. Definition,diagnosis and classification of diabetes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med,1998,15(7):539-553.
[6] Kaml GJ,Davis KA. Surgical critical care for the patient with sepsis and multiple organ dysfunction[J]. Anesthesiol Clin,2016,34(4):681-696.
[7]李超林,赵璐杰. 2型糖尿病患者医院感染病原菌分布及耐药性[J].中华医院感染学杂志,2013,23(23):5 848-5 850.
[8]李冬梅,李倩,张颖,等. 2型糖尿病患者并发院外获得性败血症24例的临床分析[J].医学研究生学报,2008,21(9):966-968.
[9]杨杰,王清,徐冬岩,等.糖尿病患者发生败血症病原菌分布及药敏性分析[J].中华医院感染学杂志,2013,23(20):5 092-5 094.
[10]翟群超,叶山东. 2型糖尿病合并血流感染研究进展[J].安徽医学,2016,37(9):1176-1178.
[11] Prestinaci F,Pezzotti P,Pantosti A. Antimicrobial resistance:a global multifaceted phenomenon[J]. Pathog Glob Health,2015,109(7):309-318.
[12]程古月,李俊,谷宇锋,等.世界卫生组织、欧盟和中国抗生素耐药性监测现状[J].中国抗生素杂志,2018,43(6):665-674.
[13]陈梦楠,杨荣礼,李璐,等.老年糖尿病合并败血症患者的病原菌分布及耐药性分析[J].实用老年医学,2016,30(9):771-773.
[14] Sun B. Nosocomial infection in China:management status and solutions[J]. Am J Infect Control,2016,44(7):851-852.
[15]佟翠艳,胡学军,李春辉. 1552例高龄住院患者院内感染分析[J].临床军医杂志,2017,45(12):1 255-1 257.
[2] Magliano DJ,Harding JL,Cohen K,et al. Excess risk of dying from infectious causes in those with type 1 and type 2diabetes[J]. Diabetes Care,2015,38(7):1 274-1 280.
[3]王冬梅.对31例老年败血症患者的临床分析[J].求医问药(学术版),2011,9(9):248-248.
[4]刘梅,张军学,张文娟,等. 35例老年患者医院感染败血症临床分析[J].中华医院感染学杂志,2010,20(22):3 478-3 479.
[5] Alberti KG,Zimmet PZ. Definition,diagnosis and classification of diabetes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med,1998,15(7):539-553.
[6] Kaml GJ,Davis KA. Surgical critical care for the patient with sepsis and multiple organ dysfunction[J]. Anesthesiol Clin,2016,34(4):681-696.
[7]李超林,赵璐杰. 2型糖尿病患者医院感染病原菌分布及耐药性[J].中华医院感染学杂志,2013,23(23):5 848-5 850.
[8]李冬梅,李倩,张颖,等. 2型糖尿病患者并发院外获得性败血症24例的临床分析[J].医学研究生学报,2008,21(9):966-968.
[9]杨杰,王清,徐冬岩,等.糖尿病患者发生败血症病原菌分布及药敏性分析[J].中华医院感染学杂志,2013,23(20):5 092-5 094.
[10]翟群超,叶山东. 2型糖尿病合并血流感染研究进展[J].安徽医学,2016,37(9):1176-1178.
[11] Prestinaci F,Pezzotti P,Pantosti A. Antimicrobial resistance:a global multifaceted phenomenon[J]. Pathog Glob Health,2015,109(7):309-318.
[12]程古月,李俊,谷宇锋,等.世界卫生组织、欧盟和中国抗生素耐药性监测现状[J].中国抗生素杂志,2018,43(6):665-674.
[13]陈梦楠,杨荣礼,李璐,等.老年糖尿病合并败血症患者的病原菌分布及耐药性分析[J].实用老年医学,2016,30(9):771-773.
[14] Sun B. Nosocomial infection in China:management status and solutions[J]. Am J Infect Control,2016,44(7):851-852.
[15]佟翠艳,胡学军,李春辉. 1552例高龄住院患者院内感染分析[J].临床军医杂志,2017,45(12):1 255-1 257.