2μm激光前列腺切除术后尿路细菌感染及抗生素耐药性研究  

Research on posterior urethral bacterial infection and antibiotic resistance after prostatectomy with 2 μm laser

作　　者：王延东[1] 

机构地区：[1]贵州省人民医院泌尿外科,贵阳550002

出　　处：《中国男科学杂志》2012年第9期46-48,52,共4页Chinese Journal of Andrology

摘　　要：目的研究经尿道2μm激光前列腺切除术后尿路的细菌感染及其抗生素耐药性。方法279例前列腺增生患者，行经尿道2μm激光前列腺切除术，术前30min应用乳酸环丙沙星0．2g，术后乳酸环丙沙星0．2g,q12h静滴，术后第4天晨应用环丙沙星0．2g静滴后采集尿液进行细菌培养及药敏实验，然后拔除尿管。分析尿液细菌培养及药敏结果。结果279例患者手术顺利，73例患者（26．2％）尿培养阳性，其中42例（15．1％）对环丙沙星耐药。总共鉴别出17种细菌，最常见的细菌是大肠埃希菌、铜绿假单胞菌．表皮葡萄球菌。耐药最常见的是氨苄西林、庆大霉素、青霉素。3例患者拔管后短期内出现发热等尿路感染症状，2例患者出现单侧睾丸附睾炎。采用敏感抗生素治疗效果良好，绝大部分病例拔管后不再使用抗生素。结论经尿道2μm激光前列腺术后尽管预防性应用氟喹诺酮类抗生素，仍然有较高的菌尿发生率，但是症状性尿路感染发生率低，根据药敏结果用药预后良好。Objective To analyze catheter-related bacterial infection and drug resistance after 2 μm laser resection of the prostate（TmLRP）. Methods In total 279 male patients with BPH were treated with TmLRP. A dose of 0.2g Ciprofloxacin was administrated intravenously once before surgery and twice a day for four days （the surgery day included） before catheter removal. Urine samples were collected immediately before catheter removal for bacteria culture test and drug sensitivity test. Results Surgery for 279 cases was successful. The urine culture of 73 patients （26.2%） was positive. Forty-two（15.1%） cases had drug resistance to ciprofloxacin. Seventeen kinds of bacteria were identified, of which the majority was Escherichia coli, pseudomonas aeruginosa and staphylococcus epidermidis. Ampicillin, gentamicin and penicillin were the three leading antibiotics to which the above bacteria resisted. Three patients had fever and two patients had unilateral epididymitis after withdrawal of catheters. They responded well to sensitivity antibiotics. Administration of antibiotics were ceased after withdrawal of canthers in most cases. Conclusion Catheter-related bacteriuria is common in patients who receive TmLRP, but the prevalence of symptomatic urinary tract is low and the prognosis is favorable after administration of sensitive antibiotics.

关 键 词：经尿道前列腺切除术 泌尿道感染 抗药性 

分 类 号：R691.3[医药卫生—泌尿科学] R983[医药卫生—外科学]