摘要
目的探讨肾结石患者输尿管软镜碎石术(URL)后发生尿路感染的原因及病原菌分布情况。方法选取2019年1月至2020年5月本院收治的行URL术的100例肾结石患者的临床资料。根据是否发生尿路感染将患者分为感染组(44例)与非感染组(56例),分析URL术后尿路感染的病原菌分布及相关影响因素,采用多因素logistic回归分析URL术后发生尿路感染的独立危险因素。结果44例肾结石术后尿路感染患者的尿液中共分离培养出50株病原菌,其中革兰阴性菌占58.00%(29/50),检出率较高的菌种为大肠埃希菌[28.00%(14/50)]、铜绿假单胞菌[20.00%(10/50)];革兰阳性菌占28.00%(14/50),其中检出最高的为金黄色葡萄球菌[14.00%(7/50)],变形菌与真菌属共检出7株(14.00%)。多因素logistic回归分析结果显示,感染性结石、术前未应用抗生素、术后出血、导尿管术后留置时间≥7 d、术前尿路感染、糖尿病史均是术后尿路感染的独立危险因素(均P<0.05);感染性结石与URL术后发生尿路感染具有相关性,且相关性最高(P<0.001)。结论URL术后发生尿路感染的影响因素较多,预防性治疗方面要多注意大肠埃希菌与铜绿假单胞菌感染情况,同时患者的感染性结石与URL术后尿路感染的相关性最高。
Objective To analyze the causes of urinary tract infection and the distribution of pathogenic bacteria after flexible ureteral lithotripsy(URL).Methods The clinical data of 100 patients with kidney stones who underwent URL surgery in our hospital from January 2019 to May 2020 were selected.The patients were divided into groups according to whether they were diagnosed with urinary tract infection,and the patients were divided into infection group(44 cases)and non-infection group(56 cases).Logistic regression analysis of factors was used to summarize the independent risk factors of urinary tract infection in patients.Results A total of 50 pathogenic bacteria were isolated and cultured in the urine of 44 patients with urinary tract infection after renal calculi surgery,of which Gram-negative bacteria accounted for 58.00%(29/50),the strains with higher detection rate were Escherichia coli 28.00%(14/50),Pseudomonas aeruginosa 20.00%(10/50),and Gram-positive bacteria accounted for 28.00%(14/50),among which Staphylococcus aureus was the highest detected[14.00%(7/50)],and 7 strains of Proteus and Fungi were detected(14.00%).Multivariate logistic regression analysis showed that infective calculi,no antibiotics used before surgery,postoperative hemorrhage,retention time≥7 days after catheter operation,preoperative urinary tract infection and history of diabetes were independent risk factors for postoperative urinary tract infection(all P<0.05).Infectious stones were associated with urinary tract infection after URL surgery,and the correlation was the highest(P<0.001).Conclusions There are many factors affecting the occurrence of urinary tract infection after URL surgery,and more attention should be paid to the infection of Escherichia coli and pseudomonas aeruginosa in preventive treatment.At the same time,patients′infectious stones have the highest correlation with urinary tract infection after URL surgery.
作者
孙孝平
王军
陈志强
Sun Xiaoping;Wang Jun;Chen Zhiqiang(Department of the Second Ward of the Intensive Care,Chengde Central Hospital,Chengde 067000,China;Department of Urology,Chengde Central Hospital,Chengde 067000,China)
出处
《国际泌尿系统杂志》
2024年第4期665-669,共5页
International Journal of Urology and Nephrology
基金
承德市科学技术局资助项目(201903A005)。
关键词
肾结石
碎石术
尿路感染
病原菌
Kidney Calculi
Lithotripsy
Urinary Tract Infection
Pathogenic Fungus
