武警医学2024，Vol.35Issue(9)：754-757,762,5.
钠-葡萄糖协同转运蛋白2抑制剂治疗2型糖尿病并发尿路感染患者的病原菌分布和耐药性分析
Analysis of pathogens and antimicrobial resistance of sodium-glucose cotransporter 2 in-hibitors in treatment of urinary tract infection in patients with type 2 diabetes
摘要
Abstract
Objective To investigate the distribution and drug resistance of pathogens associated with urinary tract infections(UTIs)in the treatment of type 2 diabetes with sodium-glucose cotransporter 2(SGLT-2)inhibitors.Methods A retrospective analy-sis was conducted on 231 patients with type 2 diabetes who were treated with SGLT-2 inhibitors and developed UTIs from January 2020 to December 2023 in Chongqing Municipal Corps Hospital of Chinese People's Armed Police Force.The distribution of pathogens and the resistance of the main isolates were analyzed using routine urine analysis,urine microbial culture and antimicrobial susceptibility testing.Results A total of 231 strains of pathogens were isolated,of which 37 were Gram-positive bacteria(16.02%),182 were Gram-negative bacteria(78.79%),and 12 were fungi(5.19%).Among the Gram-positive bacteria,18 strains were Enterococcus faecium(48.65%,18/37)and 9 strains were Enterococcus faecalis(24.32%,9/37);14 strains were multidrug-resistant bacteria(37.84%,14/37),including 7 strains each of enterococcus faecium and enterococcus faecalis.Among the Gram-negative bacteria,there were 156 strains of Escherichia coli(85.71%,156/182)and 13 strains of Klebsiella pneumoniae(7.14%,13/182);84 strains were multidrug-resistant(46.15%,84/182),of which 81 strains of Escherichia coli and 3 strains of Klebsiella pneumoniae produced extended-spectrum beta-lactamases(ESBLs).Antimicrobial susceptibility test showed that Escherichia coli had the highest resistance rate to ampicillin and ciprofloxacin(81.94%and 79.35%,respectively),but was more sensitive to carbapenems,tigecy-cline,and nitrofurantoin.Klebsiella pneumoniae demonstrated a resistance rate of 76.92%to quinolone antibiotics,but was completely sensitive to carbapenems,tigecycline,and cefepime/sulbactam.Both Enterococcus faecium and Enterococcus faecalis exhibited high resistance to a variety of antibiotics,yet showed high sensitivity to vancomycin,teicoplanin,and linezolid.Conclusions The main pathogenic bacteria in the treatment of type 2 diabetes patients with u-rinary tract infection by SGLT-2 inhibitors are Gram-negative bacteria such as Escherichia coli,with some infections also involving Gram-positive bacteria and a small amount of fungi.Due to the pharmacological mechanism of SGLT-2 inhibitors,there is a higher proportion of multidrug-resistant bacteria,and it is clinically essential to use medication rationally based on antibiogram results.关键词
2型糖尿病/钠-葡萄糖协同转运蛋白2抑制剂/尿路感染/病原菌/药敏试验Key words
type 2 diabetes/inhibitor of sodium-glucose cotransporter 2/urinary tract infection/pathogen/antimicrobial sus-ceptibility test分类
医药卫生引用本文复制引用
张春,余丽,崔龙,杨威,王晓宏..钠-葡萄糖协同转运蛋白2抑制剂治疗2型糖尿病并发尿路感染患者的病原菌分布和耐药性分析[J].武警医学,2024,35(9):754-757,762,5.基金项目
重庆市南岸区科卫联合医学科研项目(2023-04) （2023-04）
