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目的探讨糖尿病(DM)并发医院感染患者的病原菌分布及危险因素。方法选择医院2015年9月-2017年2月685例糖尿病患者,分析感染患者的感染率、病原菌分布、药敏特征及感染相关危险因素。结果 685例糖尿病患者共发生医院感染134例,感染率19.56%。感染以呼吸系统、泌尿系统感染为主。共分离174株病原菌,其中,革兰阴性菌102株占58.62%,革兰阳性菌70株占40.23%,真菌2株占1.15%。药敏结果显示,铜绿假单胞菌对亚胺培南敏感率最高为100.00%,对庆大霉素敏感率最低为52.63%。肺炎克雷伯菌对哌拉西林敏感率最高为100.00%,对庆大霉素敏感率最低为54.17%。大肠埃希菌对亚胺培南敏感率最高为95.00%,对氨苄西林敏感率最低为35.00%。金黄色葡萄球菌对苯唑西林敏感率最高为96.15%,对左氧氟沙星敏感率最低为30.77%。粪肠球菌对苯唑西林敏感率最高为100.00%,对青霉素敏感率最低为27.78%。溶血葡萄球菌对万古霉素敏感率最高为100.00%,对青霉素敏感率最低为21.43%。年龄≥60岁、住院时间≥20天、糖化血红蛋白≥9.0%、有侵入性操作、住院前15d内抗菌药物应用是DM并发医院感染的独立危险因素(P<0.05)。结论针对糖尿病并发医院感染的高危因素,加强防控措施以降低感染率。
Objective To investigate the distribution and risk factors of pathogenic bacteria in nosocomial patients with diabetes mellitus (DM). Methods A total of 685 diabetic patients from September 2015 to February 2017 in our hospital were selected to analyze the infection rate, distribution of pathogens, drug susceptibility characteristics and infection-related risk factors. Results A total of 134 cases of nosocomial infection were found in 685 diabetic patients, the infection rate was 19.56%. Infection to the respiratory system, urinary tract infections. A total of 174 strains of pathogens were isolated, of which 102 strains accounted for 58.62% of Gram-negative bacteria, 70 strains of Gram-positive bacteria accounted for 40.23% and 2 strains of fungi accounted for 1.15%. Susceptibility results showed that the sensitivity of Pseudomonas aeruginosa to imipenem was 100.00%, the lowest sensitivity to gentamycin was 52.63%. The sensitivity of Klebsiella pneumoniae to piperacillin was 100.00%, the lowest sensitivity to gentamycin was 54.17%. The highest sensitivity of E. coli to imipenem was 95.00% and the lowest sensitivity to ampicillin was 35.00%. The sensitivity of Staphylococcus aureus to oxacillin was 96.15% and the sensitivity to levofloxacin was the lowest 30.77%. Enterococcus faecalis oxacillin the highest sensitivity of 100.00%, the lowest susceptibility to penicillin 27.78%. Staphylococcus aureus to vancomycin sensitivity was 100.00%, the lowest sensitivity to penicillin 21.43%. The age ≥ 60 years, hospital stay ≥ 20 days, glycosylated hemoglobin ≥ 9.0%, invasive operation, antimicrobial use within 15 days before hospitalization was an independent risk factor for DM complicated with nosocomial infection (P <0.05). Conclusion In view of the high risk factors of nosocomial infections in diabetes mellitus, prevention and control measures should be strengthened to reduce the infection rate.