良性前列腺增生术后尿源性感染病原菌分布及危险因素  

Pathogens isolated from benign prostatic hyperplasia patients with postoperative urinary tract infection and risk factors

作　　者：胡彩花 江四平[2] 占志花[1] 郑晓红[3] 黄咏梅[3] HU Cai-hua;JIANG Si-ping;ZHAN Zhi-hua;ZHENG Xiao-hong;HUANG Yong-mei(Changshan County People′s Hospital,Quzhou,Zhejiang324200,China)

机构地区：[1]常山县人民医院手术室,浙江衢州324200 [2]常山县人民医院外科,浙江衢州324200 [3]常山县人民医院护理部,浙江衢州324200

出　　处：《中华医院感染学杂志》2021年第8期1216-1219,共4页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金资助项目(2018022110)。

摘　　要：目的分析良性前列腺增生(BPH)患者术后尿源性感染的病原菌分布及危险因素,为临床防控感染提供参考依据。方法回顾性分析2016年8月-2019年8月常山县人民医院接受手术治疗的186例BPH患者的临床资料,收集患者术后中段尿标本进行病原菌培养与鉴定,单因素和多因素Logistic回归分析术后尿源性感染的危险因素。结果186例BPH患者中有135例患者接受经尿道前列腺电切术,51例患者接受开放经耻骨上前列腺摘除术,两种术式术后尿路感染发生率分别为20.74%和17.64%,比较差异无统计学意义;感染患者尿标本共分离出41株病原菌,其中革兰阴性菌23株,占56.10%,革兰阳性菌17株,占41.46%,真菌1株,占2.44%;感染组患者血清PCT、CRP、WBC水平显著高于未感染组患者(P<0.05);多因素Logistic回归分析结果显示:年龄、合并基础病、术前导尿、前列腺体积、手术时间、导尿管留置时间均是BPH患者术后尿源性感染的独立危险因素(P<0.05)。结论年龄、合并基础病、术前导尿、前列腺体积、手术时间、导尿管留置时间均是BPH患者术后尿源性感染的独立危险因素,并且病原菌以革兰阴性菌为主,根据危险因素采取针对防控措施,合理选用抗菌药物对降低术后感染率有积极意义。OBJECTIVE METHODS To investigate the distribution of pathogens isolated from the benign prostatic hyperplasia(BPH)patients with postoperative urinary tract infection and analyze the risk factors so as to provide guidance for clinical prevention and control of the infection.METHODS A total of 186 BPH patients who received surgical procedures in Changshan County People′s Hospital from Aug 2016 to Aug 2019 were enrolled in the study,the clinical data of the patients were retrospectively analyzed.The midstream urine specimens were collected after the surgery so as to carry out culture of pathogens,the isolated pathogens were identified,and univariate analysis and multivariate logistic regression analysis were performed for the risk factors for postoperative urinary tract infection.RESULTS Among the 186 BPH patients,135 received transurethral resection of the prostate,and 51 received open transsuprapubic prostatectomy.The incidence of postoperative urinary tract infection was 20.74%among the patients undergoing the transurethral resection of the prostate,17.64%among the patients undergoing the open transsuprapubic prostatectomy,and there was no significant difference.Totally 41 strains of pathogens were isolated from urine specimens of the patients with infection,23(56.10%)of which were gram-negative bacteria,17(41.46%)were gram-positive bacteria,and 1(2.44%)was fungus.The levels of serum PCT,CRP and WBC of the infection group were significantly higher than those of the non-infection group(P<0.05).The result of multivariate logistic regression analysis indicated that the age,complication with underlying diseases,preoperative urinary catheterization,volume of prostate,operation duration and urinary catheter indwelling time were independent risk factors for the postoperative urinary tract infection in the BPH patients(P<0.05).CONCLUSION The age,complication with underlying diseases,preoperative urinary catheterization,volume of prostate,operation duration and urinary catheter indwelling time are the independent risk f

关 键 词：良性前列腺增生 前列腺切除术 病原菌分布 危险因素 

分 类 号：R619.3[医药卫生—外科学]