摘要
目的探究泌尿系感染(urinary tract infections,UTI)发生危险因素及病原菌感染分布、药物敏感性和细菌耐药性情况。方法选取晋城大医院泌尿外科2019年7月—2021年7月收治的556例需手术治疗患者的临床资料,收集患者一般资料、行手术治疗、检测尿路感染,对泌尿系感染者行细菌鉴定和药敏试验。单因素分析感染组和未感染组临床资料差异,多因素logistic回归分析影响术后发生UTI的影响因素,分析术后发生UTI患者的病原菌种类和构成,分析术后发生UTI患者的病原菌对常见抗菌药物敏感性。结果logistic回归模型分析结果显示,年龄≥60岁、吸烟(是)、合并恶性肿瘤(是)、合并基础疾病种类≥2种、留置导管时间≥5d是术后发生UTI的危险因素(OR=6.300、1.124、4.566、4.550、3.318,P<0.05);50例术后发生UTI患者的病原菌种类分析,结果检出75株病原菌。革兰阴性菌数量最多,占60.00%(45/75),其中大肠埃希菌最高,占22.67%(17/75);革兰阳性菌占33.33%(25/75);真菌感染占6.67%(5/75);肠杆菌科细菌对碳青霉烯类和β-内酰胺酶抑制剂复合物保持高度敏感,但对其他抗菌药物耐药率均较高;革兰阳性球菌耐药情况也较高,耐药性和敏感性为36.36%~100.00%;真菌对临床常用抗菌药物产生的耐药性有一定差异性。结论泌尿系统感染危险因素包括年龄、吸烟、恶性肿瘤、合并基础疾病种类和留置导管时间,感染后致病菌种类较多、耐药性较高,临床医师应做好危险因素防控和抗菌药物的合理使用,以提高良好临床预后。
Objective To explore the risk factors of urinary tract infections(UTI)and studies of the distribution of pathogenic bacteria,drug sensitivity,and bacterial resistance.Methods From July 2019 to July 2021,a total of 556 patients admitted to the Department of Urology of Jincheng General Hospital were selected.Andgeneral data on patients were collected,surgical treatment was performed,and urinary tract infection was detected.Bacterial identification and drug susceptibility tests were performed in patients with urinary tract infections.The difference in clinical data between the infected group and the uninfected group was analyzed by univariate analysis,and the risk factors affecting the occurrence of postoperative UTI were analyzed by logistic regression multivariate analysis.Pathogenic bacteria types and compositions in patients with UTI after surgery were analyzed.The pathogenic bacteria of patients with postoperative UTI were analyzed for their sensitivity and resistance to common antimicrobials.Results Logistic regression model analysis showed that age≥60 years,smoking(yes),malignant tumors(yes),≥2 types of combined underlying diseases,and catheter indwelling time≥5d were risk factors for UTI(OR=6.300,1.124,4.566,4.550,3.318,P<0.05).After the analysis of pathogenic bacteria in 50 patients with UTI,75 pathogenic bacteria were detected.The largest number of Gram-negative bacteria was 60.00%(45/75),of which Escherichia coli was the highest at 22.67%(17/75);Gram-positive bacteria accounted for 33.33%(25/75);fungal infections accounted for 6.67%(5/75);enterobacteriaceae bacteria remain highly sensitive to carbapenems and B-lactamase inhibitor complexes,but their resistance to antimicrobial drugs was relatively high.The resistance of Gram-positive cocci was also relatively high,with resistance and sensitivity of 36.36%to 100.00%.There were some differences in the resistance of fungi to antibiotics commonly used in the clinic.Conclusion Risk factors of UTI include age,smoking,malignant tumor,types of basic disease
作者
姬文娟
牛俊杰
于拽拽
聂卫静
李妮
徐春楠
JI Wenjuan;NIU Junjie;YU Zhuaizhuai;NIE Weijing;LI Ni;XU Chunnan(Department of Laboratory Medicine,Jincheng General Hospital,Shanxi 048006,China)
出处
《医学动物防制》
2023年第4期394-398,共5页
Journal of Medical Pest Control
基金
山西省卫生健康委员会科研课题(2020X5061)。
关键词
泌尿系统感染
危险因素
病原菌
分布
耐药性
Urinary system infection
Risk factors
Pathogenic bacteria
Distribution
Drug resistance
