【摘要】 目的　探讨糖尿病患者医院内下呼吸道感染的临床特点及病原菌情况。方法　回顾性调查 6 9例住院糖尿病患者合并医院内获得性下呼吸道感染的临床资料 ,分析病原菌及细菌耐药性的特点与糖代射的关系。结果　糖尿病患者下呼吸道感染的病原菌以革兰氏阴性杆菌为主 ,占 73 9% ,主要为铜绿假单胞菌18 2 % ,肺炎克雷伯杆菌 15 9% ,大肠杆菌 14 8%。 2种细菌混合感染占 14 8% ,细菌与真菌并存占 6 8%。药物敏感试验提示 :革兰氏阴性杆菌对抗菌药的敏感性依次为头孢他定 72 3%、氧氟沙星 70 8%、头孢曲松6 3 1%、头孢噻肟 6 1 5 %、头孢哌酮 6 1 5 %、头孢唑啉 6 0 0 %、哌拉西林 5 3 8%。革兰氏阳性球菌对万古霉素10 0 %敏感 ,对青霉素、红霉素等呈现不同程度的耐药 ,耐药率在 5 5 %以上。结论　糖尿病患者医院内获得性下呼吸道感染常见 ,病原菌以革兰氏阴性杆菌为主 ,应参考药物敏感试验结果并在控制血糖的基础上进行抗感染治疗。更多还原

【Abstract】 Objective To investigate the clinical manifestation and pathogen of hospital-acquired low respiratory tract infection in patients with diabetes. Methods To analyze retrospectively the clinical data, the pathogens isolated from cultured sputum and the antibiotic sensitivity of bacteria in 69 patients with diabetes. Results Bacilli in sputum were common in these patients (73.9%), including Pseudomonas aeruginosa (18.2%), Klebsiella pneumoniae (15.9%), Escherichia (14.8%) , 14.8% complicated with 2 different bacilli, 6.8% with fungus. The bacilli sensitive rate to antibiotics was as high as 72.3% to Ceftazidime, 70.8% to Ofloxacin, 63.1% to Ceftriaxone, 61.5 % to Cefotaxime and 61 5% to Cefoperazone, 60.0% to Cefazolin, 53.8% to Piperacillin respectively. Cocci sensitive rate was 100% to Vancomycin. Appeared different degree drug resistance to penicillin and erythromycin,the rate is over 55%.Conclusion Hospital acquired low respiratory tract infection is common in patients with diabetes, and should be treated based on the antibiotic sensitivity of bacteria and on metabolic control.更多还原