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目的：探讨闽东地区泌尿系结石性尿路感染的危险因素及病原学特点，旨在引起临床重视，提高泌尿系结石尿道感染患者的防治水平。方法：选取2022年11月-2023年10月宁德人民医院（n=80）及宁德市闽东医院（n=74）共计收治154例泌尿系结石患者为主要研究对象。根据患者是否发生尿路感染分为感染组与未感染组，详细统计并分析两组患者的基线资料，重点分析泌尿系结石患者发生尿路感染的危险因素及病原菌分布情况。结果：经评估154例泌尿系结石患者中发生尿路感染有33例，占21.43%。单因素分析显示：感染组的尿白细胞计数高于未感染组，且有积液、有尿路梗阻、结石位于上尿路、鹿角形结石、有吸烟史、有糖尿病、尿亚硝酸盐阳性的人数占比均高于未感染组（P＜0.05）。二元Logistic回归分析结果显示：有积液、有尿路梗阻、鹿角形结石、有吸烟史、有糖尿病、尿白细胞计数较高、尿亚硝酸盐阳性是泌尿系结石患者出现尿路感染的独立危险因素（OR＞1，P＜0.05）。33例感染组患者中共分离出33株病原菌。其中革兰阴性菌占比最高，有23株（69.70%），革兰阳性菌8株（24.24%），真菌2株（6.06%）；革兰阴性菌中大肠埃希菌占比最高（48.48%），其次是肺炎克雷伯菌（9.09%）；革兰阳性菌中粪肠球菌占比最高（12.12%），其次是屎肠球菌（6.06%），真菌中假丝酵母菌和热带念珠菌占比一样，均为3.03%。结论：闽东地区泌尿系结石患者发生尿路感染的风险较高，有积液、有尿路梗阻、鹿角形结石、有吸烟史、有糖尿病、尿白细胞计数较高、尿亚硝酸盐阳性是泌尿系结石患者出现尿路感染的独立危险因素，患者主要的尿路病原菌为革兰阴性菌。

英文摘要:

Objective:To explore the risk factors and etiological characteristics of urinary tract infection caused by urinary calculi in eastern Fujian region,in order to attract clinical attention and improve the prevention and treatment of urinary tract infection caused by urinary calculi.Method:A total of 154 patients with urinary calculi admitted to Ningde People ''s Hospital (n=80) and Ningde Mindong Hospital (n=74) from November 2022 to October 2023 were selected as the main research objects.According to whether the patients had urinary tract infection, they were divided into infection group and non-infection group. The baseline data of the two groups were analyzed in detail, and the risk factors and pathogen distribution of urinary tract infection in patients with urinary calculi were analyzed.Result:There were 33 cases of urinary tract infection in 154 patients with urinary calculi, accounting for 21.43%.Univariate analysis showed that the urinary white blood cell count in the infection group was higher than that in the non-infection group,and the proportion of patients with effusion, urinary tract obstruction,calculi in the upper urinary tract, staghorn calculi, smoking history, diabetes,and urinary nitrite positive was higher than that in the uninfected group(P<0.05)..The results of binary logistic regression analysis showed that effusion, urinary tract obstruction, staghorn calculi, smoking history, diabetes, high urine white blood cell count and positive urine nitrite were independent risk factors for urinary tract infection in patients with urinary calculi (OR>1,P<0.05). A total of 33 strains of pathogenic bacteria were isolated from 33 patients in the infection group. Among them,23 strains(69.70%) were gram-negative bacteria,8 strains (24.24%) were gram-positive bacteria, and 2 strains (6.06%) were fungi.Among gram-negative bacteria, escherichia coli accounted for the highest proportion (48.48%), followed by klebsiella pneumoniae (9.09%).Among gram-positive bacteria,enterococcus faecalis accounted for the highest proportion (12.12%),followed by enterococcus faecium (6.06%).Candida and candida tropicalis in fungi was the same,accounted for 3.03 %.Conclusion:The risk of urinary tract infection in patients with urinary calculi in eastern Fujian region is high. Effusion, urinary tract obstruction, staghorn calculi, smoking history, diabetes, high urine white blood cell count and positive urine nitrite are independent risk factors for urinary tract infection in patients with urinary calculi.The main urinary tract pathogens are gram-negative bacteria.

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