| 李 峰,陈胜龙,谢 喜,王鹏桥,李 伟.前列腺增生患者术后并发尿路感染的病原菌分布、耐药性和危险因素分析[J].,2019,19(16):3155-3159 |
| 前列腺增生患者术后并发尿路感染的病原菌分布、耐药性和危险因素分析 |
| Analysis of Distribution, Drug Resistance and Risk Factors of Pathogens Causing Postoperative Urinary Tract Infections in Patients with Benign Prostatic Hyperplasia |
| 投稿时间：2019-01-21 修订日期：2019-02-19 |
| DOI：10.13241/j.cnki.pmb.2019.16.031 |
| 中文关键词: 前列腺增生 尿路感染 病原菌 耐药性 危险因素 |
| 英文关键词: Benign prostatic hyperplasia Urinary tract infection Pathogenic bacteria Drug resistance Risk factors |
| 基金项目:四川省教育厅科研课题重点项目（18ZA0165） |
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| 中文摘要: |
| 摘要 目的：探讨前列腺增生患者术后并发尿路感染的病原菌分布、耐药性和危险因素。方法：回顾性分析2014年6月到2018年10月期间成都医学院第一附属医院行手术治疗的323例前列腺增生患者的临床资料，采用单因素和多因素Logistic回归分析方法分析前列腺增生患者术后并发尿路感染的危险因素。收集所有患者术后12h内的中段尿样，进行病原菌检测和耐药性分析。结果：323例前列腺增生患者共有50例术后并发尿路感染，发生率为15.48%，50例术后并发尿路感染患者的尿液标本中共分离出53株病原菌，其中革兰阳性菌23株，占43.40%，革兰阴性菌27株，占50.94%，真菌3株，占5.66%。屎肠球菌对青霉素、红霉素耐药性较高，粪肠球菌对青霉素、红霉素、氨苄西林耐药性较高，屎肠球菌和粪肠球菌对万古霉素、呋喃妥因的耐药性较低。大肠埃希菌对氨曲南、氨苄西林、左氧氟沙星耐药性较高，铜绿假单胞菌对氨曲南、氨苄西林耐药性较高，大肠埃希菌和铜绿假单胞菌对亚胺培南的耐药性较低。经单因素分析显示，前列腺增生患者术后并发尿路感染与年龄、前列腺体积、手术时间、术后留置尿管时间、是否合并糖尿病、术前是否预防性应用抗生素有关（P<0.05），多因素Logistic回归分析结果显示，年龄≧65岁、手术时间≧60 min、术后留置尿管时间≧7d、合并糖尿病、术前未预防性应用抗生素均是前列腺增生患者术后并发尿路感染的危险因素（P<0.05）。结论：前列腺增生患者术后易出现尿路感染，感染病原菌以革兰阴性菌和革兰阳性菌为主，临床应根据尿路感染的危险因素和药敏实验结果而采取针对性的防治措施。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the distribution, drug resistance and risk factors of postoperative urinary tract infection in patients with benign prostatic hyperplasia. Methods: The clinical data of 323 patients with benign prostatic hyperplasia who were treated in First Affiliated Hospital of Chengdu Medical College from June 2014 to October 2018 were retrospectively analyzed. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of postoperative urinary tract infections in patients with benign prostatic hyperplasia. Urine samples during 12h after operation were collected from all patients, and pathogen detection and drug resistance were analyzed. Results: There were 50 cases of urinary tract infection in 323 patients with benign prostatic hyperplasia, and the incidence of urinary tract infection was 15.48%. 53 strains of pathogenic bacteria were isolated from 50 urine samples of patients with postoperative urinary tract infection. Among them, there were Gram-positive bacteria with 23 strains, accounting for 43.40%, there were Gram-negative bacteria with 27 strains, accounting for 50.94%, there were fungi with 3 strains, accounting for 5.66%. The resistance of Enterococcus faecium to penicillin and erythromycin was higher. The resistance of Enterococcus faecalis to penicillin, erythromycin and ampicillin was higher, and the resistance of Enterococcus faecium and Enterococcus faecalis to vancomycin and furadantin was lower. The resistance of Escherichia coli to aztreonam, ampicillin and levofloxacin was higher. The resistance of pseudomonas aeruginosa to aztreonam and ampicillin was higher. The resistance of Escherichia coli and Pseudomonas aeruginosa to imipenem was lower. Univariate analysis showed that postoperative urinary tract infection in patients with benign prostatic hyperplasia was related to age, prostate volume, operation time, postoperatively indwelling catheter time, combined with or not diabetes and preoperatively prophylactic use or not antibiotics (P<0.05). The results of multiple factors analysis showed that the age ≥65 years old, the operation time ≥60 min, postoperatively indwelling catheter time ≥7d, combined with diabetes and preoperatively prophylactic use antibiotics were the risk factors of postoperative urinary tract infection in patients with benign prostatic hyperplasia(P<0.05). Conclusion: Urinary tract infection is easy to occur in patients with benign prostatic hyperplasia after operation. The main pathogens are Gram-negative bacteria and Gram-positive bacteria,and clinical measures should be taken according to the risk factors of urinary tract infection and the results of drug sensitivity test. |
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