摘要
目的 对糖尿病住院患者呼吸系统医院感染病原菌的分布及主要病原菌的药敏性进行调查,为糖尿病住院患者呼吸系统医院感染的经验性预防和治疗提供参考.方法 回顾性分析69例糖尿病并发呼吸系统医院感染的住院患者临床资料,所有患者实验室、影像学、病原学检查资料保存完整,检测标本为:咽拭子、痰涂片、痰培养、保护性标本刷取样等,经病原学培养、鉴定,并对鉴定分离的致病菌进行药敏实验,统计69例患者资料及预后情况.结果 69例患者相关标本经病原学培养、分离、鉴别,共检出病原菌86株,其中革兰阳性菌46株,革兰阴性菌27株,真菌13株.金黄色葡萄球菌、肺炎链球菌、表皮葡萄球菌对替考拉宁、克林霉素、阿莫西林、左氧氟沙星的药敏率<50%,而对苯唑西林、万古霉素、利奈唑胺、氨苄西林、亚胺培南、莫西沙星药敏率>50%.铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌对头孢曲松、头孢他啶、阿莫西林、阿米卡星药敏性<50%,对头孢噻吩、哌拉西林/他唑巴坦、复方新诺明、亚胺培南、美罗培南、奈替米星药敏率>50%.69例患者确诊前予以经验性抗生素、抗病毒药物治疗,再根据病原学及药敏检测结果调整抗生素及抗病毒药物,49例患者感染获得改善,14例患者转至上级医院治疗,6例患者转为败血症经抢救无效死亡.结论 糖尿病住院患者呼吸系统医院感染病原菌范围较广,病原菌药敏性差异较大,定期了解此类患者病原菌分布及药敏情况,对经验性预防和治疗提供指导,降低患者呼吸系统医院感染率,提高感染患者治疗的针对性具有重要的意义.
Abstract
Objective To investigate the drug sensitivity and distribution of main pathogenic pathogens in hospitalized patients with respiratory hospital diabetes bacteria and provide reference for the prevention and treatment of diabetes mellitus in experimental infection in patients with respiratory hospital.Methods 69 cases of diabetes mellitus complicated with respiratory infection were selected, their clinical data ( laboratory, imaging and etiological examination data) were complete,and their intact specimens for testing and identificated were throat swabs, sputum smear, sputum culture, protected specimen brush sampling, pathogens culture, and drug susceptibility test of pathogenic bacteria were isolated from the statistical data of 69 patients and prognosis.Results 69 strains of pathogenic bacteria were isolated, identified and isolated from the specimens of all the patients in the study.Among them, there were a total of 86 strains of pathogenic bacteria, including gram positive bacteria (46 strains), gram negative bacteria (27 strains) and fungi (13 strains) .Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis to teicoplanin, clindamycin, amoxicillin and levofloxacin sensitive rate is less than 50%, while to oxacillin, vancomycin, linezolid, ampicillin, imipenem, moxifloxacin susceptibility rate >50%.Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae to ceftriaxone, ceftazidime, amoxicillin, amikacin drug sensitivity of less than 50% of cefoxitin, piperacillin/tazobactam, cotrimoxazole, imipenem, meropenem, netilmicin susceptibility rate >50%.69 patients were diagnosed before treatment with antiviral drugs, antibiotics, antibiotics adjusted according to the etiology and drug sensitivity test results and antiviral drugs, improved in 49 cases of patients to the hospital treatment of 14 cases, 6 cases were converted to sepsis after rescue invalid death.Conclusion The diabetic patients hospitalized in respiratory pathogens of nosocomial infection in a wide range of pathogen susceptibility differences , understand the distribution of pathogens in patients with regular and drug resistance, provide guidance for the prevention and treatment experience, reduce the infection rate of patients with respiratory infection in patients with hospital provided treatment of high pertinence has important significance.
NETL
NSTL
维普
万方数据