【摘要】  目的  观察2DM合并尿路感染病原菌分布特点和药敏结果，并探讨其发生的危险因素。方法  分析T2DM合并尿路感染患者的临床特点及病原学特征。  结果  T2DM合并尿路感染的发生率为6.85%(210/3065), T2DM合并尿路感染组较T2DM组年龄大、病程长，FPG,尿素氮、肌酐、IAA及24 h尿白蛋白/肌酐（24 hUAlb）水平高,白蛋白水平低（P＜0.05）。Logistic回归分析显示，女性、年龄、糖尿病病程、IAA，24 hUAlb是发生尿路感染的危险因素，白蛋白为保护因素。分离出的210株病原菌以革兰氏阴性菌为主(84.2%)，前3种病原菌为大肠埃希菌(65.2%)、粪肠球菌（6.2%)和肺炎克雷伯菌(5.2%)。革兰氏阴性菌对美罗培南（100%）、头孢哌酮舒巴坦(99.2%)和阿米卡星(99.2%)敏感性较高，对头孢噻吩（38.1%）、哌拉西林（35.7%）、替卡西林[替卡拉林没有这个词，请核实是否为替卡西林]（28.6%）和阿莫西林（28.2%）敏感性较低。  结论  老年、女性、糖尿病病程长及肾功能不全的T2DM患者更易发生尿路感染，T2DM合并尿路感染的病原菌仍以革兰氏阴性菌为主，但细菌谱发生了一定的变化，且多重耐药菌呈明显上升趋势。 

   【关键词】  糖尿病,2型；尿路感染；危险因素　

   Risk factors and etiological characteristics of urinary tract infection in type 2 diabetes mellitus  

   【Abstract】  Objective  To explore the risk factors for urinary tract infections in type 2 diabetes mellitus（T2DM）by analyzing the pathogens distribution characteristics and drug sensitivity.  Methods  A total of 3,065 T2DM patients were retrospectively analyzed for the clinical and etiological characteristics of urinary tract infections in T2DM. All patients enrolled in the study were divided into two groups: T2DM with urinary tract infection group (n=210) and simple T2DM group (n=132). Data harvested were analyzed by SPSS 19.0.  Results  Of 3,065 patients with T2DM the incidence of urinary tract infection was 6.85%. Compared with T2DM group, patients in T2DM+ urinary tract infection group were older, with longer duration of diabetes, higher levels of FPG, urea nitrogen, creatinine, IAA and 24 hUAlb, and lower levels of serum albumin (P<0.05). Logis-tic regression analysis showed that age, gender, duration of diabetes, IAA and 24 hUAlb were risk factors and albumin was protective factor for urinary tract infection in T2DM. 84.2% was gram-negative bacteria among the 210 isolated strains of pathogenic bacteria. The top three pathogens were Escherichia coli (65.2%), Entero-coccus faecalis (6.2%) and Klebsiella pneumoniae (5.2%). Gram-negative bacteria had high sensitivity to merope-nem (100%), cefoperazone sulbactam (99.2%) and amikacin (99.2%) but low sensitivity to cephalothin (38.1%), pipera-cillin (35.7%), ticarcillin (28.6%) and amoxicillin (28.2%).  Conclusion  T2DM patients who have the factors including female, advanced age, long course of diabetes and renal insufficiency are prone to suffer from urinary tract infection. Gram-negative bacteria are the most common pathogens in T2DM patients with uri-nary tract infection but bacteria spectrum has changed with percentage of multiple resistant bacteria rising dramatically.

   【Key words】  Diabetes melltius,type 2；Urinary tract infection；Risk factors