泌尿结石感染发生危险因素及病原菌感染分布特点和耐药性分析  

Analysis of the risk factors of urinary stone infection and the distribution characteristics and drug resistance of pathogenic bacteria

作　　者：李晓石 张慧明 李世宾 LI Xiaoshi;ZHANG Huiming;LI Shibin(Department of Urology,the Fourth Clinical College of Xinxiang Medical College,Xinxiang Central Hospital,Xinxiang 453000,Henan,China)

机构地区：[1]新乡市中心医院,新乡医学院第四临床学院泌尿外科,河南新乡453000

出　　处：《中国病原生物学杂志》2025年第4期499-502,507,共5页Journal of Pathogen Biology

摘　　要：目的 系统性探究泌尿结石感染发生危险因素,同时分析病原菌感染分布特点和耐药性。方法 选取2022年1月-2024年5月期间本院泌尿外科收治的行手术治疗且术后感染的泌尿系统结石患者35例作为研究组,另选取同期于本院行手术治疗但术后未感染的泌尿系统结石患者200例作为对照组。对研究组患者行细菌鉴定和药敏试验。单因素分析研究组和对照组临床资料差异;Logistic回归分析泌尿结石患者术后感染的独立危险因素;分析泌尿结石患者术后感染患者病原菌分布特点;分析泌尿结石患者术后感染患者常见病原菌耐药性。结果 研究组年龄≥60岁、饮酒史和留置导管时间≥1周占比均明显高于对照组(均P<0.05);Logistic回归结果显示年龄(OR=3.331)、吸烟(OR=3.766)和留置导管时间(OR=4.268)是尿结石患者术后感染的独立危险因素(均P<0.05);35例泌尿结石患者术后感染患者共检出80例病原菌,分别为革兰阴性菌(73.75%)、革兰阳性菌(22.50%)和真菌(3.75%);革兰阴性菌中大肠埃希菌对头孢哌酮、美洛西林、阿莫西林、氨苄西林耐药性较高,肺炎克雷伯菌对头孢哌酮和氨苄西林耐药率较高,铜绿假单胞菌对头孢呋辛、阿莫西林、氨曲南和氨苄西林有较强的耐药性(耐药率均≥80%);革兰阳性菌中粪肠球菌对头孢克肟、头孢哌酮、头孢曲松和氨苄西林有较强的耐药性,屎肠球菌对头孢克肟、头孢哌酮、头孢曲松、苯唑西林和氨苄西林有较强的耐药性;金黄色葡萄球菌对头孢克肟、头孢哌酮、头孢曲松和红霉素有较强的耐药性(耐药率均≥80%)。结论 年龄≥60岁、吸烟和留置导管时间≥1周是泌尿结石患者术后感染的独立危险因素。而感染患者检出的病原菌以革兰阴性菌为主,其次为革兰阳性菌和真菌。不同病原菌对多种抗菌药物存在较强耐药性,临床应重视相关危险因素,合理选择抗菌药物,以Objective To systematically explore the risk factors of urinary stone infection,and analyze the distribution characteristics and drug resistance of pathogenic bacteria.Methods Thirty-five patients with urinary calculi who underwent surgical treatment and were infected after surgery from January 2022 to May 2024 in the Department of Urology of our hospital were selected as the study group.Another 20o patients with urinary calculi who underwent surgical treatment in our hospital during the same period but were not infected after surgery were selected as the control group.The patients in the study group were subjected to bacterial identification and drug susceptibility tests.The difference of clinical data between study group and control group was analyzed by single factor.The independent risk factors of postoperative infection in patients with urinary stones were analyzed by Logistic regression.The distribution characteristics of pathogenic bacteria in postoperative infection patients with urinary calculi were analyzed.The drug resistance of common pathogenic bacteria in postoperative infection of urinary calculus patients was analyzed.Results The proportion of age≥60 years old,drinking history and catheter retention time≥1 week in study group were significantly higher than those in control group(all P<o.05).Logistic regression results showed that age(OR=3.331),smoking(OR=3.766)and catheter indentation time(OR=4.268)were independent risk factors for postoperative infection in patients with urinary calculus(all P<0.05).A total of 80 pathogens were detected in 35 patients with urinary calculi,including gram-negative bacteria(73.75%),gram-positive bacteria(22.50%)and fungi(3.75%).Among gram-negative bacteria,Escherichia coli had high resistance to cefoperazone,melocillin,amoxicillin and ampicillin,Klebsiella pneumoniae had high resistance rate to cefoperazone and ampicillin,and Pseudomonas aeruginosa had strong resistance to cefuroxime,amoxicillin,amtronam and ampicillin(resistance rate≥80%).Enterococcus faecali

关 键 词：泌尿结石 术后感染 危险因素 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R699[医药卫生—临床医学]