Analysis Of The Clinical Characteristics And Drug Sensitivity In Diabetic With Klebsiella Pneumoniae Pneumonia

Objective: Analysis the clinical characteristics and drug sensitivity in diabetic with klebsiella pneumoniae pneumonia and provide experiential antimicrobial treatment in patients of this part.Methods: Retrospective analysis the 159 cases of pneumonia in diabetic hospitalized in the First Hospital of Ji Lin University from January 2014 to December 2015. According to the results of the pathogen culture separation of bacteria for 32 cases of patients with klebsiella pneumoniae. Analyzing their clinical characteristics, analyzed pathogen drug sensitivity, applied SPSS 17.0 statistical software for the data statistics and analysis.Results: 1. Crowd baseline characteristics: In 32 cases, 22 cases(68.8%) were male, 10 cases(31.2%) were female; the age range was from 40~88 years old,the average age was 67.41±14.36 years old, 22 cases(68.8%)were with course clear more than 5 years, complications of patients with diabetes were 29cases(90.6%), 26 cases(81.2%) combined other basic diseases. In 32 cases of patients, the length of hospital stay was from 2 days to 31 days, the average length of hospital stay was 12.94±7.762 days, 24 cases(75%) of the patients were improved after anti-infection treatment, the death and not cured patients both were 4 cases(12.5%). 2. Clinical manifestation: In 32 cases, 22 cases(68.8%) of the patients were with fever, lung infection symptoms and signs and pulmonary infection patients were 29 cases(90.6%), patients with pleural effusion were 6 cases(18.8%). 3. Laboratory and imaging examination: In 32 cases, 27 cases(84.4%) of the patients were with higher glycosylated hemoglobin level than that in normal patients, 25 cases(78.1%) have higher blood leukocyte count and neutrophil percentage, 22 cases(68.8%) of patients were with the lung CT or the Chest X-ray prompted pneumonia. 4. Drug Sensitivity: 32 cases were cultured 32 strains klebsiella pneumonia, the antibacterial drugs with drug sensitive rate is 100% contained meropenem and cefepime.The antibacterial drugs with drug sensitive rate more than 80% are imipenemd>ceftazidime > piperacillin/tazobactam > gentamycin > cefotetan > tobramycin >cefotaxime>amikacin>ciprofloxacin>cefoperazone/sulbactam>ticarcillin /clavulanic acid>aztrenam>levofloxacin>ceftriaxone>cotrimoxazole>piperacillin>cefoxitin. High resistance of antimicrobial agents are nitrofurantoin(50%), cefoxitin(33.3%), Ampicillin/Sulbactam(27.7%).Conclusion: 1. Penicillium carbon alkene, the fourth generation and the third generation cephalosporins, cephamycins, part of the β-lactam antibiotics compound preparations, aztrenam were high susceptibility to klebsiella pneumonia, should cause the attention of clinicians. 2. We should avoid application of high resistance with klebsiella pneumonia, such as cefuroxime and ampicillin/ sulbactam antimicrobials. 3. In clinic, in diabetic patients with pneumonia, such as highly suspected klebsiella pneumoniae infection, we should according to the result of drug susceptibility, combines the condition of individual patients, illness weight, drug safety, efficacy, bacteria resistance as the selection of antimicrobial agents.