大肠埃希菌定植对卵巢癌患者术后泌尿系统感染的影响  

Influence of Escherichia coli colonization on postoperative urinary tract infection in patients with ovarian cancer

作　　者：朱艳清[1] 吴菊英[1] 朱维培[1] ZHU Yan-qing;WU Ju-ying;ZHU Wei-pei(Second Affiliated Hospital of Suzhou,Suzhou,Jianigsu 215000,China)

机构地区：[1]苏州大学附属第二医院妇科

出　　处：《中华医院感染学杂志》2019年第22期3473-3476,3484,共5页Chinese Journal of Nosocomiology

基　　金：江苏省科研基金资助项目(F201709)

摘　　要：目的探讨大肠埃希菌定植对卵巢癌患者术后泌尿系统感染的影响,分析临床情况并筛选影响因素。方法选取2015年6月-2017年1月苏州大学附属第二医院妇科收治的确诊为卵巢癌并行手术治疗的患者98例(病例组),同时配对对照组98例。统计两组发生泌尿系统感染的例数,纸片扩散法进行药敏检测。同时进一步进行卵巢癌患者术后大肠埃希菌定植与泌尿系统感染的单因素分析和多因素分析。结果病例组患者的感染率、感染情况和泌尿系统感染临床症状发生率均高于对照组,差异均有统计学意义(P<0.05)。药敏结果显示,对常用抗菌药物耐药率最高的是氨苄西林和一代头孢菌素类抗菌药物。大肠埃希菌定植患者的病原菌培养对常用抗菌药物敏感性最高的是亚胺培南。多因素Logistic回归分析显示,患者的导尿管留置时间、合并基础性疾病(如糖尿病、高血压、肿瘤、结核等)、多种抗菌药物的使用是影响患者术后泌尿系统感染的因素。结论医院感染大肠埃希菌定植发生时,卵巢癌手术患者术后泌尿系统感染发生率升高。大肠埃希菌定植与感染的发生与留置导尿管时间、使用多种抗菌药物、合并基础性疾病等相关。OBJECTIVE To explore the influence of Escherichia coli colonization on postoperative urinary tract infection in patients with ovarian cancer,analyze the clinical situation and screen influencing factors.METHODS A total of 98 patients who were diagnosed with ovarian cancer and received surgical procedures in the gynecology department of Second Affiliated Hospital of Suzhou from Jun 2015 to Jan 2017 were assigned as the case group,and 98 patients were matched as the control group.The number of cases of urinary tract infection was statistically analyzed,the drug susceptibility testing was performed by using disk diffusion method.The univariate analysis and multivariate analysis were performed for the postoperative E.coli colonization and urinary tract infection in the ovarian cancer patients.RESULTS The infection rate,status of infection and incidence of clinical symptoms of urinary tract infection were higher in the case group than in the control group,and there were significant differences(P<0.05).The result of drug susceptibility testing showed that the drug resistance rates to the commonly used antibiotics ampicillin and first generation cephalosporins were the highest.The drug susceptibility rate of the pathogens isolated from the patients with colonized E.coli was the highest to imipenem.The multivariate logistic regression analysis showed that the urinary catheter indwelling time,complication with underlying diseases(diabetes mellitus,hypertension,tumor,tuberculosis)and use of multiple antibiotics were the influencing factors for the postoperative urinary tract infection.CONCLUSION The incidence rate of postoperative urinary tract infection is increased in the ovarian cancer patients when they are colonized with E.coli.The colonization and infection with E.coli are associated with the urinary catheter indwelling time,use of multiple antibiotics and complication with underling diseases.

关 键 词：大肠埃希菌 细菌定植 卵巢癌 感染 

分 类 号：R73[医药卫生—肿瘤]