[1]顾玉凤,李晓莹,冷蓓峥.2型糖尿病合并感染患者肺炎克雷伯菌分布及预后影响因素分析[J].陕西医学杂志,2024,(4):491-495.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.012]
　GU Yufeng,LI Xiaoying,LENG Beizheng.Analysis of the distribution and prognostic factors of Klebsiella pneumoniae in patients with type 2 diabetes co-infection[J].,2024,(4):491-495.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.012]
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2型糖尿病合并感染患者肺炎克雷伯菌分布及预后影响因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年4期
页码:
491-495
栏目:
临床研究
出版日期:
2024-04-05

文章信息/Info

Title:
Analysis of the distribution and prognostic factors of Klebsiella pneumoniae in patients with type 2 diabetes co-infection
作者:
顾玉凤; 李晓莹; 冷蓓峥
(复旦大学附属上海市第五人民医院感染二科,上海 200240)
Author(s):
GU Yufeng; LI Xiaoying; LENG Beizheng
(Second Department of Infection,Shanghai Fifth People's Hospital,Fudan University,Shanghai 200240,China)
关键词:
2型糖尿病;  肺炎克雷伯菌;  耐药率;  多位点序列;  预后;  危险因素
Keywords:
Type 2 diabetes mellitus;  Klebsiella pneumoniae;  Drug resistance rate;  Multi-site sequence;  Prognosis;  Risk factor
分类号:
R 587.1
DOI:
DOI:10.3969/j.issn.1000-7377.2024.04.012
文献标志码:
A
摘要:
目的:探讨2型糖尿病(T2DM)合并感染患者肺炎克雷伯菌(KP)分布及预后影响因素分析。方法:选择226例T2DM患者为研究对象,根据是否合并KP感染分为未感染组(n=170)和感染组(n=56),分析T2DM患者感染的危险因素。收集T2DM合并感染患者KP标本,记录标本来源并进行菌种鉴定和药敏试验,并对所有菌株进行多位点序列(MLST)分型,记录预后情况。结果:基础疾病、抗生素使用、侵入性操作、血清白蛋白(ALB)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)为影响T2DM发生感染的危险因素(均P<0.05)。T2DM合并感染患者体内分离56株肺炎克雷伯菌,肺炎克雷伯菌在痰液中的占比最高为44.62%,其次为尿液19.64%,血液中占比16.07%,脓液中占比12.5%,其他标本占比7.14%。56株KP总耐药率最高为氨苄西林,最低为亚胺培南,痰液标本中KP对头孢呋辛、头孢哌酮、庆大霉素耐药率高于非痰液标本,非痰液标本中KP对头孢他啶高于痰液标本(均P<0.05)。56株肺炎克雷伯菌MLST分型共发现42个ST型,ST-20型、36型、65型、347型、660型各2株,分别占3.57%,23型4株占7.14%,ST-17、25、29、35、37、45、86、189、208、211、218、322、355、412、490、519、557、595、726、776、1049、1092、1103、1319、1569、1916、2059、3014、3140、3536、4023、4194、4262、4412、4857型各1株,分别占1.78%,其他ST型7株占比12.5%。56例T2DM合并KP感染患者预后良好患者52例,预后不良患者4例,预后良好率为92.86%。结论:T2DM合并感染患者KP主要分布在痰液和尿液中,基础疾病、抗生素使用、侵入性操作、ALB、HbA1c、FPG是影响KP感染发生危险因素,T2DM合并KP感染患者根据药敏结果选择用药,有利于患者预后。
Abstract:
Objective:To investigate the distribution and prognostic factors of Klebsiella pneumoniae(KP)in patients with type 2 diabetes mellitus(T2DM)co-infection.Methods:A total of 226 T2DM patients were selected as study subjects and divided into uninfected group(n=170)and infected group(n=56)according to whether they were infected with KP.The risk factors of infection in T2DM patients were analyzed.KP samples of T2DM patients with co-infection were collected,the source of specimens was recorded,strain identification and drug sensitivity test were performed,and all strains were classified by multi-site sequence(MLST),and the prognosis was recorded.Results:Underlying disease,antibiotic use,invasive operation,ALB,HbA1c,FPG were the risk factors for T2DM infection(all P<0.05).56 strains of KP were isolated from patients with T2DM co-infection.The proportion of Klebsiae pneumoniae in sputum was the highest(44.62%),followed by urine(19.64%),blood(16.07%),pus(12.5%)and other specimens(7.14%).The highest and lowest drug resistance rates of 56 strains of KP were ampicillin and imipenem.The drug resistance rates of KP to cefuroxime,cefoperazone and gentamicin in sputum samples were higher than that in non-sputum samples,and ceftazidime in non-sputum samples was higher than that in sputum samples(all P<0.05).A total of 42 ST types were found in the MLST typing of 56 strains of KP,including 2 strains of ST-20,36,65,347 and 660,accounting for 3.57%,respectively,and 4 strains of type 23 accounting for 7.14%.ST-17,25,29,35,37,45,86,189,208,211,218,322,355,412,490,519,557,595,726,776,1049,1092,1103,1319,1569,1916,2059,3014,3140,35 36,4023,4194,4262,4412 and 4857 strains each accounted for 1.78%,and other ST types accounted for 12.5%.Among 56 T2DM patients with KP infection,52 had good prognosis,4 had poor prognosis,and the good prognosis rate was 92.86%.Conclusion:KP is mainly distributed in sputum and urine in patients with T2DM co-infection.Underlying diseases,antibiotic use,invasive procedures,ALB,HbA1c,and FPG are risk factors for KP infection.In patients with T2DM co-infection,medication selection based on drug sensitivity is beneficial to the prognosis of patients.

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备注/Memo

备注/Memo:
基金项目:上海市闵行区卫生健康委员会科研计划课题(2021MW13)
更新日期/Last Update: 2024-04-07