泌尿系肿瘤患者留置尿管感染的临床分析  

Clinical characteristics of indwelling catheter-related infections in urinary tract tumor patients

作　　者：何丽莉[1] 胡利平[1] 李丽璇[1] 

机构地区：[1]海口市人民医院泌尿外科,海南海口570208

出　　处：《中华医院感染学杂志》2014年第17期4262-4263,4268,共3页Chinese Journal of Nosocomiology

基　　金：国家临床重点专科基金资助项目(卫办医政函2012-649);海南省医学重点学科基金资助项目(琼卫科教2011-18)

摘　　要：目的探讨泌尿系肿瘤患者留置尿管感染的临床特点和相应的干预措施,以减少泌尿系肿瘤患者留置尿管导致感染。方法选取2007年3月-2013年5月泌尿系肿瘤行留置尿管患者2 237例,对患者的临床资料、治疗情况进行回顾性分析,并记录感染患者的致病菌。结果 2 237例患者共发生医院感染134例,感染率为5.99%;女性、年龄≥70岁、合并糖尿病、留置导尿管时间较长、进行膀胱冲洗、未预防性应用抗菌药物是泌尿系肿瘤患者发生感染的危险因素(P<0.05);共分离病原菌134株,其中革兰阳性菌78株占58.21%,以粪肠球菌、屎肠球菌为主,革兰阴性菌51株占38.06%,以大肠埃希菌为主,真菌5株占3.73%,以白色假丝酵母菌为主。结论泌尿系肿瘤患者留置尿管造成感染与多种因素有关,在临床工作中应积极预防,一旦发生感染,应选择敏感抗菌药物进行针对性治疗。OBJECTIVE To explore the clinical characteristics of indwelling catheter-related infections in the urinary tract tumor patients and put forward corresponding intervention measures so as to reduce the incidence of indwelling catheter-related urinary tract infections. METHODS A total of 2 237 patients with urinary tract tumors who underwent catheter indwelling were enrolled in the study, then the clinical data and treatment of the two groups of patients were retrospectively analyzed, and the pathogenic bacteria causing infections were recorded. RESULTS The nosocomial infections occurred in 134 of 2 237 patients with the infection rate of 5.99%. The female, no less than 70 years of age, complication of diabetes, long-term catheter indwelling, bladder irrigation, and without prophylactic use of antibiotics were the risk factors for the infections in the patients with urinary tract tumors （P〈0.05）. Totally 134 strains of pathogens have been isolated, including 78 （58. 21%） strains of gram-positive bacteria, 51 （38.06%） strains of gram-negative bacteria, and 5 （3.73%） strains of fungi; the Enterococcus faecalis and Enterococcus feces were the predominant species of gram-positive bacteria, the Escherichia coli was dominant among the gram-negative bacteria, and the Candida albicans was the predominant species of fungi. CONCLUSION The indwelling catheter-related infections in the patients with urinary tract tumors are associated with a variety of factors; positive prevention measures should be taken, once the infections occur, the sensitive antibiotics should be used for targeted treatment.

关 键 词：泌尿系统 肿瘤 留置导尿 感染 

分 类 号：R737[医药卫生—肿瘤]