宫颈癌根治术患者泌尿系统感染情况、病原菌特征及其危险因素分析

目的分析宫颈癌患者根治术后泌尿系统感染情况、病原菌分布特征及其危险因素。方法选择2017年1月-2019年5月在本院接受宫颈癌根治术患者158例,统计分析患者术后出现泌尿系统感染情况,感染病原菌种类、分布、耐药性,以及影响泌尿系统感染的相关因素。结果158例宫颈癌根治术患者中有65例术后出现感染,占比41.14%,其中泌尿系统感染占32.91%(52/158)。52例泌尿系统感染患者共检出86株病原菌,其中革兰阴性菌52株(占60.47%),革兰阳性菌29株(占33.72%),以大肠埃希菌(占33.72%)、粪肠球菌(占15.12%)、肺炎克雷伯菌(占9.30%)、表皮葡萄球菌(占9.30%)为主。肺炎克雷伯菌、大肠埃希菌对庆大霉素、四环素、甲氧苄啶/磺胺异恶唑的耐药率均>50.0%,对亚胺培南、美罗培南的耐药性均<10.0%;粪肠球菌对红霉素的耐药性较高,对万古霉素、氨苄西林的耐药率为0;表皮葡萄球菌对青霉素G、庆大霉素、左氧氟沙星的耐药率均>50.0%,对万古霉素、利奈唑胺、呋喃妥因的耐药率为0。Logistic多因素分析显示,年龄、贫血、接受辅助治疗、手术时间>180min以及住院时间>12d是宫颈癌术后泌尿系统感染的高危因素(均P<0.05)。结论宫颈癌患者根治术后泌尿系统感染发生率高,高龄、手术和住院时间长等是感染发生的主要危险因素;感染病原菌以革兰阴性菌多见,且对常用抗菌药物有一定耐药性,可为临床提供参考。

Prevalence of a urinary tract infection,characteristics of pathogenic bacteria causing them,and risk factors in patients undergoing radical surgery for cervical cancer

Objectives To analyze the prevalence of urinary tract infections,the distribution of pathogenic bacteria causing them,and risk factors in patients with cervical cancer after radical surgery.Methods Subjects were 158 patients who underwent radical surgery for cervical cancer at this Hospital from January 2017 to May 2019.Urine samples were collected from all patients with a urinary tract infection to detect pathogens.The resistance of the main pathogens to common antibiotics was determined.The incidence of a urinary tract infection,the type,distribution,and drug resistance of pathogens,and factors related to development of a urinary tract infection were analyzed.Results Of 158 patients with cervical cancer,65(41.14%)had a postoperative infection.A urinary system infection accounted for 32.91%(52/158)of those infections.A total of 86 strains of pathogenic bacteria were detected in 52 patients with a urinary tract infection,including 52 strains of Gram-negative bacteria(60.47%)and 29 strains of Gram-positive bacteria(33.72%).Escherichia coli(33.72%),Enterococcus faecalis(15.12%),Klebsiella pneumoniae(9.30%),and Staphylococcus epidermidis(9.30%)were the main pathogens causing a urinary tract infection.The resistance of Klebsiella pneumoniae and Escherichia coli to gentamicin,tetracycline,and trimethoprim/sulfamethoxazole was higher than 50.0%,and their resistance to imipenem and meropenem was lower than 10.0%.Enterococcus faecalis was highly resistant to erythromycin,and its resistance to vancomycin and ampicillin was 0%.The resistance of Staphylococcus epidermidis to penicillin G,gentamycin,and levofloxacin was higher than 50.0%,and its resistance to vancomycin,linezolid,and nitrofurantoin was0%.Logistic multivariate analysis indicated that age,anemia,adjuvant treatment,operating time>180 min,and hospitalization>12 dwere high-risk factors for development of a urinary tract infection(P<0.05).Conclusion There is a high incidence of a urinary tract infection in patients undergoing radical surgery with cervical cancer,and the main risk factors for development of an infection are being elderly,a long operating time,and prolonged hospitalization.Gram-negative bacteria were the most common pathogens causing infections,and they were resistant to common antibiotics.Thesefindings can provide a reference for clinical practice.