摘要
目的探讨脊柱手术住院患者术后发生泌尿系统感染的病原学特征以及危险因素。方法选择2014年10月至2017年12月在本院接受脊柱手术的400例住院患者为研究对象,分析其泌尿系统感染情况,病原菌的分布及耐药情况,并采用多因素Logistic回归分析探讨脊柱手术术后泌尿系统感染的相关危险因素。结果 400例患者中,共42例发生泌尿系统感染,感染率为10.50%,对感染患者进行病原菌培养,共分离菌株61株,其中革兰阳性菌19株,占31.15%,革兰阴性菌34株,占55.74%,真菌8株,占13.11%;常见革兰阴性菌对氨苄西林耐药性最高,对头孢哌酮/舒巴坦耐药性最低,常见革兰阳性菌对万古霉素敏感,常见真菌对氟康唑、两性霉素B、氟胞嘧啶耐药性均较低。多因素Logistic回归分析结果显示,年龄≥60岁、留置尿管时间≥5天、有侵入性操作、住院天数≥40天、使用激素、合并基础疾病、围术期使用抗生素、白细胞计数> 2.0×109/L均为脊柱手术术后泌尿系统感染的独立危险因素(P_均<0.05)。结论脊柱手术住院患者较易发生泌尿系统感染,病原菌以革兰阴性菌为主,常见病原菌对多种抗菌药物呈现较高耐药性,需引起重视,采取相应措施进行干预。
Objective To investigate the etiology characteristics and risk factors of postoperative urinary tract infection in hospitalized patients underwent spinal surgery. Method A total of 400 inpatients underwent spinal surgery from October 2014 to December 2017 in our hospital were selected as subjects. Their urinary tract infections, distribution and drug resistance of pathogens were analyzed, and the related risk factors of urinary tract infcetion after spinal surgery were analyzed by multivariate Logistic regression analysis. Result Among the 400 patients, 42 patients had urinary tract infection with an infection rate of 10.50%. The infected patients were cultured with pathogens, and 61 strains were isolated, including 19 Gram-positive bacteria, accounting for 31.15%, and Gram-negative bacteria 34 Strain, accounting for 55.74%, 8 strains of fungi, accounting for 13.11%. Common Gramnegative bacteria have the highest resistance to Ampicillin, and the lowest resistance to Cefoperazone/Sulbactam. Common Grampositive bacteria sensitive to Vancomycin, and common fungi have low resistance to Fluconazole, Amphotericin B, and Flucytosine. Multivariate Logistic analysis showed that age ≥ 60 years, the time of indwelling catheter ≥ 5 days, invasive operation, hospital day ≥ 40 days, used hormone combined with underlying diseases, perioperative antibiotics use, white blood cell count 〉 2.0 × 109/L were independent risk factors for urinary tract infection after spinal surgery （Pall 〈 0.05）. Conclusion Inpatients with spinal surgery are more prone to urinary tract infections. It is important to develop a comprehensive treatment and nursing system for the relevant risk factors and corresponding pathogenic characteristics.
作者
杨宇莹
蒋琳
曹静
YANG Yu-ying;JIANG Lin;CAO Jing(EmergencyoTrauma Center Clinic,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中国医学前沿杂志（电子版）》
2018年第11期120-123,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
