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目的分析T2DM合并血流感染的病原菌分布及其药敏特征,为临床早期诊断及选用抗菌药物提供依据。方法回顾性分析2009年1月至2014年12月66例T2DM合并血流感染病例的临床资料,并进行比较。结果入选病例共培养分离出病原菌66株,其中,革兰氏阴性菌47株(71.2%)、革兰氏阳性菌19株(28.8%);革兰氏阴性菌以大肠埃希菌(19株)和肺炎克雷伯菌(16株)为主,产超广谱β内酰胺酶(ESBLs)菌检出率为29.8%;感染部位以呼吸道(23例)、泌尿道(17例)及胆道(11例)多见;多数革兰氏阳性菌属对青霉素及氨苄西林耐药率高,对万古霉素和替考拉宁敏感性高;大肠埃希菌及肺炎克雷伯菌对氨苄西林耐药率分别为68.4%及100%,对亚胺培南和美罗培南敏感性为100%。结论 T2DM患者合并血流感染病原菌以革兰氏阴性菌多见,主要为大肠埃希菌及肺炎克雷伯菌,临床应结合血培养结果合理选择抗菌药物。
Objective To analyze the distribution of pathogens and their susceptibility to T2DM complicated with bloodstream infection, and to provide basis for early diagnosis and selection of antimicrobial agents. Methods The clinical data of 66 T2DM patients with bloodstream infection from January 2009 to December 2014 were retrospectively analyzed and compared. Results 66 strains of pathogens were isolated from co-culture in the selected cases, of which 47 (71.2%) were Gram-negative bacteria and 19 (28.8%) were Gram-positive bacteria. Gram-negative bacteria were Escherichia coli ) And Klebsiella pneumoniae (16 strains). The detection rate of ESBLs was 29.8%. The infection sites were respiratory tract (23 cases), urinary tract (17 cases) and biliary tract (11 cases) more common; most of Gram-positive bacteria penicillin and ampicillin resistant rate is high, high sensitivity to vancomycin and teicoplanin; Escherichia coli and Klebsiella pneumoniae ampicillin The drug resistance rates were 68.4% and 100% respectively, and the sensitivity to imipenem and meropenem was 100%. Conclusion The pathogens of T2DM patients with bloodstream infection are more common with Gram-negative bacteria, mainly Escherichia coli and Klebsiella pneumoniae. In clinical practice, antimicrobial drugs should be selected reasonably in combination with the results of blood culture.