Bacterial analysis of pulmonary infection in patients with diabetes mellitus complicated with different clinical phenotypes

Abstract

Objective To investigate the pathogenic conditions of pulmonary infection in patients with diabetes. Methods Total of 208 patients with diabetes complicated with pulmonary infection of different clinical manifestations were divided into three groups: respiratory symptoms group (RS group), systemic symptom group (SS group) and comprehensive syndrome group (CS group), and the pathogen of their sputum were cultured for 232 strains, and the statistical analysis was carried out by SPSS 16.0 software. Results Mixed infection (19.13%) in CS group was significantly higher than those of the RS group (4.00%) and the group SS (11.39%). In patients of the RS group, the infection rate of Gram positivecocci(G+C) was 20%, which were 69.6% in the SS group and 33.9% in the CS group, with significant difference (χ2= 9.90,P= 0.001). G-B infection rate of patients of the RS group was 76%, which were 25.3% in the SS group and 59.3% in the CS group, with significant difference (χ2 = 14.87,P= 0.001). The resistance rates ofStaphylococcusto moxifloxacin, azithromycin, clindamycin, gentamicin, erythromycin, levofloxacin, ciprofloxacin, tetracycline, penicillin, rifampicin, cefuroxime and ceftizoxime of the RS group were significantly lower than those of SS group and CS group (allP< 0.05). The resistance rates ofStreptococcusto azithromycin, moxifloxacin, clindamycin, erythromycin, tetracycline, cefuroxime and ceftizoxime in the SS group were significantly lower than those of the CS group (allP< 0.05). The resistance rates ofEnterococcusto moxifloxacin, gentamicin and ceftizoxime in patients of the SS group were significantly lower than those of in the CS group (allP< 0.05). In patients of the RS group, the resistance rates ofKlebsiella pneumoniato imipenem, cefoperazone, cefoperazone sulbatam, piperacillin tazobactam, cefotaxime, cefotaxime, ceftazidime, ceftizoxime, gentamicin, ciprofloxacin, levofloxacin, aztreonam and ampicillin were significantly lower than those of the SS group and CS group (allP< 0.05). In patients of the RS group, the resistance rates ofPseudomonas aeruginosaandAcinetobacterto cefoperazone sulbatam, piperacillin tazobactam, cefotaxime, cefotaxime, ceftazidime, ceftizoxime, gentamicin, ciprofloxacin, levofloxacin, aztreonam and ampicillin were significantly lower than those of SS group and CS group (allP< 0.05). Conclusions The bacterial spectrum distribution of patients with diabetes combined with pulmonary infection of different clinical phenotypes were different. In view of the above infection characteristics, it is helpful to guide clinical antiinfection treatment. Key words: Diabetes; Pulmonary infection; Clinical phenotype; Bacterial spectrum