摘要
目的分析肾结石输尿管软镜碎石术后尿路感染的病原菌分布特点及相关危险因素。方法选择2017年5月—2020年5月南通大学附属南京江北人民医院泌尿外科收治的行输尿管软镜碎石术肾结石患者189例作为研究对象,根据患者是否存在尿路感染将其分为感染组43例与非感染组146例,分析尿路感染的病原菌分布特点,采用多因素Logistic回归分析尿路感染的独立危险因素。结果43例肾结石术后尿路感染患者尿液中共分离培养出病原菌62株,其中革兰阴性菌38株(61.29%),检出率较高的有大肠埃希菌(24.19%)、铜绿假单胞菌(16.13%)、肺炎克雷伯菌(8.06%);革兰阳性菌16株(25.81%),检出率最高的为肠球菌(11.29%);真菌8株(12.90%),检出率最高的为白色念珠菌(6.45%)。多因素Logistic回归分析结果显示,术前尿白细胞>2个/HP、术前留置输尿管支架、术前未应用抗生素、中重度肾积水、手术时长>60 min、术后输尿管导管留置时长>7 d、合并糖尿病是肾结石术后尿路感染的独立危险因素(P均<0.05)。结论肾结石术后尿路感染患者病原菌多以大肠埃希菌、铜绿假单胞菌、肠球菌为主,存在多种独立危险因素。
Objective To analyze the distribution characteristics of pathogenic bacteria and related risk factors of urinary tract infection after soft ureteroscopic lithotripsy.Methods From May 2017 to May 2020,189 patients with nephrolithiasis who underwent flexible ureteroscope lithotripsy admitted to the Department of Urology,Nanjing Jiangbei People’s Hospital,Nantong University were selected as the research objects,and the patients were divided into infection groups according to whether they had urinary tract infection.43 cases and 146 cases in the non-infected group were analyzed to analyze the distribution characteristics of pathogenic bacteria of urinary tract infection,and multivariate Logistic regression was used to analyze the independent risk factors of urinary tract infection.Results A total of 62 pathogenic bacteria were isolated and cultured in the urine of 43 patients with urinary tract infection after renal calculus surgery,of which 38 were gram-negative bacteria(61.29%).The detection rate was Escherichia coli(24.19%)and aeruginosa.Monascus(16.13%),Klebsiella pneumoniae(8.06%);16 Gram-positive bacteria(25.81%),the highest detection rate is Enterococcus(11.29%);8 fungi(12.90%),The highest detection rate was Candida albicans(6.45%).Multivariate logistic regression analysis showed that preoperative urinary white blood cells>2/HP,preoperative indwelling ureteral stent,preoperative no antibiotics,moderate to severe hydronephrosis,operation duration>60 min,postoperative ureteral catheter indwelling duration>7 d.Diabetes is an independent risk factor for urinary tract infection after nephrolithiasis(all P<0.05).Conclusion The pathogens of patients with urinary tract infection after renal calculus surgery are mostly Escherichia coli,Pseudomonas aeruginosa,and Enterococcus,and there are many independent risk factors.
作者
徐建华
杨元强
李巍
许飞
Xu Jianhua;Yang Yuanqiang;Li Wei;Xu Fei(Department of Urology, Nanjing Jiangbei People's Hospital affiliated to Nantong University, Nantong 210048, China)
出处
《疑难病杂志》
CAS
2020年第12期1217-1220,1224,共5页
Chinese Journal of Difficult and Complicated Cases
基金
江北人民医院省级科研培育项目(JKK201901)。
关键词
肾结石
输尿管软镜碎石
术后尿路感染
病原菌
危险因素
Kidney stones
Ureteroscope flexible lithotripsy
Urinary tract infection
Postoperative
Pathogenic bacteria
Risk factors
