| Objective:To investigate the distribution and composition ratio of pathogens of 2 type diabetes mellitus(T2DM)with urinary tract infections,the bacterial drug resistance analysis and the univariate and multivariate analysis,to provide a reference for the prevention and control for the early selection of antimicrobial in the treatment of T2 DM with urinary tract infections.Methods:1.The object of study: a retrospective analysis from June 2012 to June 2016 of the clinical datas of 502 patients with T2 DM,and to improve the effectiveness and accuracy of the results,it was essential to carry out the following text inclusion and exclusion criteria of the standard.2.Study methods: the incidence of T2 DM with urinary tract infections,the distribution of pathogenic bacteria and drug resistance were observed and analyzed.The T2 DM with(or without)urinary tract infections in patients with age,sex,duration of diabetes,glycosylated hemoglobin level,fasting plasma glucose level,combined antimicrobial drugs application and hospitalization time were compared and analyzed,and to analyze the related risk factors of T2 DM with urinary tract infections.Results:1.Clinical data analysis:in 502 patients who met the inclusion criteria,one hundred and twenty-six cases were diagnosed as urinary tract infection,which the infection rate was 25.1%.2.The distribution and composition ratio of pathogens of T2 DM with urinary tract infections:In the urine samples of the patients with urinary tract infection,a total of 131 strains of bacteria were isolated.among them,gram-negative bacteria had the highest proportion(104 strains,79.39%),Escherichia coli was the main pathogenic bacteria(73strains,55.73%).secondly,the gram-positive bacteria(23 strains,17.56%)and fungi(4strains,3.05%).3.the bacterial drug resistance analysis of T2 DM with urinary tract infections:in the gram negative bacteria,the drug resistance rates of Escherichia coli to ampicillin,piperacillin,etimicin were higher.The drug resistance rates of Klebsiella pneumoniae to ciprofloxacin,ampicillin were higher.The drug resistance rates of Proteus mirabilis to ciprofloxacin,sulfamethoxazole/trimethoprim were higher,both more than 50%.No strains resistant to imipenem of such three kinds of gram negative bacteria were detected.No strains resistant to cefepime,ceftriaxone,cefotaxime,ceftazidime of Proteus mirabilis were detected.The drug resistance rates of such three kinds of gram negative bacteria to piperacillin/tazobactam and Amikacin were lower,which were less than 30%.In gram positive bacteria,the drug resistance rates of Enterococcus faecalis to tetracycline,streptomycin,ciprofloxacin,and erythromycin were high,which were more than 60%.The drug resistance rates of Enterococcus faecalis to penicillin G,ampicillin,streptomycin,ciprofloxacin,erythromycin,levofloxacin reached 100%.The drug resistance rates of Staphylococcus epidermidis to penicillin G,ampicillin,cefazolin,imipenem reached 100%.No strains resistant to vancomycin of such three kinds of gram positive bacteria were detected.No strains resistant to penicillin G,ampicillin of Enterococcus faecalis were detected.No strains resistant to nitrofurantoin of Staphylococcus epidermidis were detected.4.The related factors analysis of T2 DM with urinary tract infections:the univariate analysis showed the incidence of T2 DM complicated with urinary tract infection was correlated with the patient’s age,duration of diabetes,glycosylated hemoglobin level,fasting plasma glucose level,combined antimicrobial drugs application and hospitalization time(P<0.05).Logistic regression analysis results showed that the occurrence of T2 DM complicated with urinary tract infection was correlated with age,duration of diabetes,glycosylated hemoglobin level,fasting plasma glucose level,combined antimicrobial drugs application and hospitalization time(P<0.05).Conclusion:Type 2 diabetes mellitus(T2DM)with urinary tract infection rates is higher,which the gram-negative bacteria is main part and poor resistance to cephalosporins antibiotics,so clinical medical staff for elderly patients,especially patients with disease bout saccharification control is poorer,long,should give early intervention,in the case of uncertain infection bacteria,can the early use of cephalosporins antibiotics,improve the efficiency of infection prevention and control,in order to achieve the purpose of improving the prognosis of patients... |
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