摘要
目的探讨子宫肌瘤患者术后并发泌尿系统感染病原菌分布、耐药性及危险因素。方法选取2020年5月至2022年9月于本院接受手术治疗的314例子宫肌瘤患者作为研究对象,根据术后是否并发泌尿系统感染分为感染组(n=82)与非感染组(n=232),对感染组患者开展细菌分离培养,对分离获取的病原菌实施药物敏感试验;并采用Logistic回归模型分析影响子宫肌瘤患者术后并发泌尿系统感染的危险因素。结果82例子宫肌瘤患者术后并发泌尿系统感染患者经细菌培养分离出86株病原菌,其中革兰阳性菌29株(32.80%),革兰阴性菌48株(65.73%),真菌9株(10.47%)。药敏结果显示,肠球菌属对磺胺甲噁唑/甲氧苄啶的耐药率最高,其次为红霉素、四环素;金黄色葡萄球菌对红霉素的耐药率最高,其次为磺胺甲噁唑/甲氧苄啶、呋喃妥因;大肠埃希菌对氨苄西林的耐药性最高,其次为头孢吡肟、头孢他啶;铜绿假单胞菌对氨苄西林的耐药性最高,其次为头孢噻肟、头孢他啶。感染组与非感染组在合并糖尿病、术前预防性应用抗菌药物、留置导尿管时间等差异有统计学意义(χ^(2)=12.905、7.465、6.052,均P<0.05)。Logistic回归模型中分析,结果显示,合并糖尿病(B=0.973,OR=2.646)、术前未预防性应用抗菌药物(B=0.731,OR=2.077)、留置导尿管时间>48 h(B=0.734,OR=2.083)是影响子宫肌瘤患者术后并发泌尿系统感染的危险因素(均P<0.05)。结论子宫肌瘤患者术后并发泌尿系统感染以肠球菌属、金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌多见,且合并糖尿病、术前未预防性应用抗菌药物、留置导尿管时间>48 h会对患者并发泌尿系统感染产生影响。
Objective To investigate the distribution,drug resistance and risk factors of pathogenic bacteria associated with urinary system infection in patients with uterine fibroids after operation.Methods A total of 314 patients with uterine fibroids who received surgical treatment in our hospital from May 2020 to September 2022 were selected as the study objects,and divided into an infected group(n=82)and a non-infected group(n=232)according to whether they were complicated with urinary system infection after surgery.Bacteria isolation and culture were performed on patients in the infected group,and drug sensitivity tests were performed on the isolated pathogens.Logistic regression model was used to analyze the risk factors of postoperative urinary infection in patients with uterine fibroids.Results 86 strains of pathogenic bacteria were isolated from 82 patients with postoperative uterine fibroids complicated with urinary system infection,of which 29 were gram-positive(32.80%),48 were gram-negative(65.73%)and 9 were fungi(10.47%).The results showed that the resistance rate of Enterococcus to sulfamethoxazole/trimethoprim was the highest,followed by erythromycin and tetracycline.The resistance rate of Staphylococcus aureus to erythromycin was the highest,followed by sulfamethoxazole/trimethoprim and furantoin.Escherichia coli had the highest resistance to ampicillin,followed by cefepime and ceftazidime.The resistance of Pseudomonas aeruginosa to ampicillin was the highest,followed by cefotaxime and ceftazidime.There were significant differences between the infected group and the non-infected group in patients with diabetes mellitus,preoperative prophylactic use of antibiotics,and indinduration catheter time(χ^(2)=12.905,7.465,6.052,all P<0.05).Logistic regression model analysis showed that patients with diabetes mellitus(B=0.973,OR=2.646),no preventive use of antibiotics before surgery(B=0.731,OR=2.077),indwelling catheter time>48 h(B=0.734,OR=2.083)was a risk factor for postoperative urinary system infection in patients with uterine fibroids(all P<0.05).Conclusion Enterococcus,S.aureus,E.coli and P.aeruginosa were the most common postoperative urinary system infections in patients with uterine fibroids.In addition,diabetes mellitus,non-prophylactical application of antibiotics before surgery,and indurating catheter time>48h would have an impact on the patients'urinary system infections.
作者
徐洪霞
严敏
陈丽敏
廖莉苹
贺腊
刘晓琴
XU Hongxia;YAN Min;CHEN Limin;LIAO Liping;HE La;LIU Xiaoqin(Health Management Center of Jianyang People's Hospital in Sichuan Province,Jianyang 641400,Sichuan,China;Infection Management Department of Jianyang People's Hospital in Sichuan Province;Obstetrics and Gynecology Department of Jianyang People's Hospital in Sichuan Province;Laboratory Department of Jianyang People's Hospital,Sichuan Province;Gynecology Department of Sichuan Cancer Hospital)
出处
《中国病原生物学杂志》
CSCD
北大核心
2024年第9期1096-1099,1108,共5页
Journal of Pathogen Biology
基金
四川省卫生健康委员会课题(No.21PJ136)。
关键词
子宫肌瘤
泌尿系统感染
病原菌
耐药性
危险因素
uterine fibroids
Urinary system infection
pathogenic bacteria
drug resistance
risk factor
