CAJ | 학술논문

目的：分析严重肝病伴糖尿病患者大肠埃希菌血流感染的临床特点及耐药性，为临床合理应用抗菌药物提供依据。方法回顾性分析2009年至2012年住院的严重肝病合并糖尿病血流感染大肠埃希菌患者的临床特点及药敏结果。结果严重肝病合并糖尿病血流感染大肠埃希菌患者共47例，基础疾病以肝硬化为主，感染来源以自发性细菌性腹膜炎为主，ESBL阳性22株，阳性率46．81％。ESBL阳性大肠埃希菌耐药性高于 ESBL 阴性大肠埃希菌，但两者在年龄、性别、基础疾病、原发病灶、体温峰值、白细胞计数及中性粒细胞百分比等方面比较均差异无统计学意义，发生感染性休克者的病死率要高于无感染性休克者。结论严重肝病合并糖尿病患者血流感染病情危重，预后不良，应尽早进行正确的综合治疗和抢救以降低病死率。
목적：분석엄중간병반당뇨병환자대장애희균혈류감염적림상특점급내약성，위림상합리응용항균약물제공의거。방법회고성분석2009년지2012년주원적엄중간병합병당뇨병혈류감염대장애희균환자적림상특점급약민결과。결과엄중간병합병당뇨병혈류감염대장애희균환자공47례，기출질병이간경화위주，감염래원이자발성세균성복막염위주，ESBL양성22주，양성솔46．81％。ESBL양성대장애희균내약성고우 ESBL 음성대장애희균，단량자재년령、성별、기출질병、원발병조、체온봉치、백세포계수급중성립세포백분비등방면비교균차이무통계학의의，발생감염성휴극자적병사솔요고우무감염성휴극자。결론엄중간병합병당뇨병환자혈류감염병정위중，예후불량，응진조진행정학적종합치료화창구이강저병사솔。
Objective To investigate the clinical characteristic and drug resistance of bloodstream infections caused by Escherichia coli (E.coli)in patients with severe liver diseases and diabetes,and to provide evidence for optimal therapy of antibiotics in clinical practice. Methods The clinical features and drug susceptibility of E.coli-caused bloodstream infections among inpatients with severe liver diseases and diabetes from 2009 to 2012 were analyzed retrospectively. Results A total of 47 strains of E. coli were isolated from those inpatients,among which 22 strains of extended-spectrumβ-lactamases (ESBLs)(46.81% )were positive. The overwhelming majority patients were liver cirrhosis with infection resulting from spontaneous bacterial peritonitis. The drug resistance of ESBLs-positive strains was higher than that of ESBLs-negative strains,with no statistical differences existed in age,sex,basic disease,infection source,peak temperature,white blood cell count and the percentage of neutrophils between ESBLs-positive strains and negative strains. Mortality rate in patients accompanied with septic shock was higher than that in patients without shock. Conclusion Due to the severity and bad prognosis of bloodstream infection,early identification and comprehensive treatment should be taken to reduce mortality.