【摘要】 目的:探讨合并2型糖尿病(DM)对慢性阻塞性肺疾病急性加重(AECOPD)患者病原学及耐药性的影响,为更有效的抗感染治疗提供参考依据。方法:选出2015年12月-2017年12月某院住院的AECOPD合并2型糖尿病的感染患者102例和AECOPD无糖尿病患者140例,回顾性分析患者临床资料,比较2组病原菌及耐药率的异同。结果:观察组分离出致病菌共152株,包括104株革兰阴性菌(69.3%),12株革兰阳性菌(7.9%),36株真菌(23.7%)。对照组分离出致病菌184株,包括146株革兰阴性菌(79.5%),14株革兰阳性菌(7.6%)、24株真菌(13.0%)。检出的主要病原菌有大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯杆菌、嗜麦芽窄食单胞菌、葡萄球菌属、白色念珠菌等。观察组中细菌混合感染有30例,对照组24例;观察组分离出多药耐药菌26株,对照组21株。观察组革兰阴性菌对头孢吡肟、头孢他啶、左氧氟沙星、庆大霉素、氨曲南、哌拉西林他唑巴坦、亚胺培南等抗菌药物的耐药性明显高于对照组。结论:合并2型糖尿病能明显增加AECOPD患者下呼吸道革兰阴性菌和真菌感染的机会,同时也升高革兰阴性菌等致病菌混合感染的几率,并且增加了病原菌对抗菌药物的耐药性。更多还原

【Abstract】 OBJECTIVE To investigate the effect of type 2 diabetes mellitus(DM) on etiology and drug resistance of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and to provide reference for more effective clinical treatment. METHODS A total of 102 patients with AECOPD complicated with type 2 diabetes and 140 patients without AECOPD who were hospitalized from December 2015 to December 2017 were selected. The clinical data of the patients were analyzed retrospectively, and the similarities and differences of pathogens and drug resistance rates between the two groups were compared. RESULTS In the observation group, 152 strains of pathogenic bacteria were isolated, including 104 strains of gram-negative bacteria(69.3%), 12 strains of gram-positive bacteria(7.9%) and 36 strains of fungi(23.7%).84 strains of pathogenic bacteria were isolated in the control group, of which 146 were Gram-negative bacteria(79.5%), 14 strains were Gram-positive bacteria(7.6%), and 24 strains were fungi(13.0%).The major pathogens detected were Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus, Candida albicans. There were 30 cases of mixed bacterial infection in the observation group and 24 cases in the control group. 26 strains of multidrug resistant bacteria were isolated in the observation group and 21 strains in the control group. The resistance of Gram-negative bacteria to cefepime, ceftazidime, levofloxacin, gentamicin, aztreonam and piperacillin was significantly higher than that of control group. CONCLUSION Diabetes mellitus can not only significantly increase the incidence of fungal infection in patients with lower respiratory tract infection of AECOPD, but also increase the probability of mixed infection of pathogenic bacteria as well as the antibiotic resistance of pathogens.更多还原