妊娠期糖尿病孕妇尿路感染的临床特征与危险因素分析
Analysis of clinical characteristics and risk factors of urinary tract infection in pregnant women with gestational diabetes mellitus
凌勇 1赵越 1梁雪冰 1陈晓丽 1叶龙 1刘洁2
作者信息
- 1. 南方医科大学附属广东省人民医院(广东省医学科学院)检验科,广州 510080
- 2. 南方医科大学附属广东省人民医院(广东省医学科学院)生殖医学科,广州 510080
- 折叠
摘要
目的 探讨妊娠期糖尿病(GDM)孕妇发生尿路感染的临床特征与相关危险因素.方法 选取2017年1月至2021年12月在本院收治的289例确诊为GDM的孕妇,对GDM孕妇发生尿路感染的发病率、病原菌分布以及耐药性进行回顾性分析,并采用logistic回归模型分析GDM孕妇发生尿路感染的相关危险因素.结果 289例GDM孕妇中有32例发生尿路感染,发病率为11.07％.洁净中段尿培养共检出32株病原菌,其中以大肠埃希菌为主[53.13％(17/32)],其次是无乳链球菌[15.63％(5/32)].大肠埃希菌对氨苄西林耐药率较高,对阿米卡星、β-内酰胺酶抑制剂合剂、碳青霉烯类等抗菌药物耐药率较低.单因素分析结果显示,三酰甘油(TG)、糖化血红蛋白(HDL-C)、高密度脂蛋白胆固醇(HbA1c)均是GDM孕妇发生尿路感染的危险因素(均P＜0.05).多因素分析结果显示,TG是GDM孕妇发生尿路感染的独立危险因素(OR=1.276,95％CI:1.066～1.526,P＜0.05).结论 TG与GDM孕妇尿路感染的发生有关,临床上可采取相应措施,以降低尿路感染的发病率,并根据患者病情合理选择抗菌药物.
Abstract
Objective To investigate the clinical characteristics and related risk factors of uri-nary tract infection in pregnant women with gestational diabetes mellitus(GDM).Methods A total of 289 pregnant women diagnosed with GDM admitted to our hospital from January 2017 to December 2021 were selected for retrospective analysis of the incidence,pathogen distribution and drug resistance of urinary tract infections in pregnant women with GDM.Logistic regression model was used to analyze the risk factors associated with urinary tract infections in pregnant women with GDM.Results Among 289 pregnant women with gestational diabetes mellitus,32 cases had urinary tract infection,the inci-dence rate was 11.07％.A total of 32 strains of pathogenic bacteria were detected,of which Esche-richia coli[53.13％(17/32)]was the main pathogen,followed by Streptococcus agalactiae[15.63％(5/32)].Escherichia coli has a high resistance rate to Ampicillin,and a low resistance rate to antibacterial drugs such as Amikacin,β-lactamase inhibitor mixtures,and Carbapenems.Uni-variate analysis showed that triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),glyco-sylated hemoglobin(HbA1c)were risk factors for urinary tract infection in pregnant women with GDM(P＜0.05).Multivariate logistic regression analysis showed that TG were independent risk factors for urinary tract infection in pregnant women with GDM(OR=1.276,95％CI:1.066-1.526,P＜0.05).Conclusions TG is associated with the occurrence of urinary tract infection in pregnant women with GDM.Appropriate measures should be taken to reduce the incidence of urinary tract infection and to rationally choose antimicrobial drugs according to the patient's condition.
关键词
孕妇/糖尿病/尿路感染Key words
Pregnant Women/Diabetes Mellitus/Urinary Tract Infection引用本文复制引用
出版年
2024
NETL
NSTL
万方数据