泌尿外科儿童留置导尿管相关尿路感染的临床特征及护理对策

目的:探讨泌尿外科儿童留置导尿管相关尿路感染的临床特征及护理对策。方法:对532例泌尿外科住院患儿留置导管尿路感染发生率、相关因素、感染病原菌分布、耐药性监测进行回顾性分析。结果:患儿留置导管尿路感染发生率为13.3%。尿路感染率女性患儿明显高于男性患儿(P<0.01);7~15岁患儿尿路感染率显著高于1~6岁患儿(P<0.01);导尿管留置8~14 d患儿尿路感染率亦明显高于导尿管留置1~7 d患儿(P<0.01)。尿路感染的病原菌以粪肠球菌、大肠埃希菌和屎肠球菌为主,分别占28.0%、22.7%和21.3%。21株粪肠球菌对氨苄西林和青霉素敏感性为100.0%,对庆大霉素、利福平和米诺环素耐药率较高;14株屎肠球菌对青霉素和氨苄西林耐药率均为87.5%,对万古霉素、呋喃妥因、替考拉宁、利奈唑胺敏感度较高;16株大肠埃希菌对氨苄西林和哌拉西林的耐药率均为94.1%,而17株均对亚胺培南敏感。结论:尿路感染率与性别、年龄和留置时间有关。有必要采取有效护理措施减少减少导尿管相关尿路感染的发生率。

Clinical features of the urinary tract infection caused by indwelling urethral catheter in children of urinary surgery and its nursing countermeasure

Objective:To explore the clinical features of the urinary tract infection caused by indwelling urethral catheter in children of urinary surgery and its nursing countermeasures. Methods:The clinical data of the incidence, related factors, pathogenic bacteria distribution and drug resistance surveillance of urinary tract infection in 532 children with indwelling urethral catheter in department of urology were retrospectively analyzed. Results:The incidence of urinary tract infection in children with indwelling catheter was 13. 3%. The urinary tract infection rate in female children was higher than that in male children(P<0. 01). The urinary tract infection rate in 7 to 15 years old children was higher than that in 1 to 6 years old children(P<0. 01). The urinary tract infection rate in children with indwelling urethral catheter for 8 to 14 days was higher than that in children with indwelling urethral catheter for 1 to 7 days ( P <0. 01). The main pathogenic bacteria of urinary tract infection were enterococcus faecalis,escherichia coli and enterococcus faecium in turn,which accounted for 28. 0%,22. 7% and 21. 3%,respectively. Both the sensitivities of 21 strains of enterococcus faecalis to ampicillin and penicillin were 100. 0%,but the sensitivities of enterococcus faecalis to gentamicin,rifampicin and minocycline were high. Both the resistant rates of enterococcus faecium to penicillin and ampicillin were 87. 5%,but the sensitivities of enterococcus faecium to vancomycin,nitrofurantoin,teicoplanin and linezolid were high. Both the resistant rate of escherichia coli to ampicillin and piperacillin were 94. 1%,and it was sensitive to imipenem. Conclusions:Urinary tract infection is associated with gender,age,and indwelling time. It is necessary to take effective nursing measures to reduce the incidence of urinary tract infection caused by catheter.