良性前列腺增生患者术后尿源性感染病原菌及危险因素

目的分析良性前列腺增生(Benign prostatic hyperplasia,BPH)患者术后尿源性感染病原菌分布及高危因素。方法选择2018年1月-2019年12月衡水市人民医院泌尿外科接受经尿道前列腺切除术治疗的204例BPH患者,根据术后是否发生尿源性感染,分为感染组37例和未感染组167例,无菌留取感染患者中段尿进行病原菌培养与鉴定,回顾性分析患者年龄、体质量指数(BMI)、基础合并症、是否进行术前导尿、前列腺大小、手术时间、术中出血量、术后留置导管时间等临床资料,采用单因素及多因素Logistic回归模型分析患者术后尿源性感染的危险因素。结果 204例BPH患者发生尿源性感染37例,感染率为18.14%;中段尿共分离出病原菌43株,主要为大肠埃希菌(27.91%)、屎肠球菌(20.93%)和肺炎克雷伯菌(18.60%);合并糖尿病、术前导尿和术后留置导尿管时间>3 d是BPH患者尿源性感染的独立危险因素。结论 BPH患者术后尿源性感染病原菌以大肠埃希菌为主,临床需重点关注合并糖尿病、术前导尿和术后留置导尿管时间>3 d的患者。

Distribution of pathogens isolated from benign prostatic hyperplasia patients with postoperative urinary tract infection and risk factors

OBJECTIVE To investigate the distribution of pathogens isolated from benign prostatic hyperplasia(BPH)patients with postoperative urinary tract infection and analyze the high risk factors.METHODS A total of 204 BPH patients who underwent transurethral resection of the prostate(TURP)in Hengshui People′s Hospital from Jan 2018 to Dec 2019 were enrolled in the study and were divided into the infection group with 37 cases and the non-infection group with 167 cases according to the status of postoperative urinary tract infection,the midstream urine specimens were collected from the patients with infection.The clinical data,including the age,body mass index(BMI),underlying complications,preoperative urethral catherization,size of prostate,operation duration,intraoperative blood loss volume and postoperative catheter indwelling time,were retrospectively analyzed,and univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the postoperative urinary tract infection.RESULTS Of the 204 BPH patients,37 had urinary tract infection,with the infection rate 18.14%.Totally 43 strains of pathogens were isolated from the midstream urine specimens,27.91%of which were Escherichia coli,20.93%were Enterococcus faecium,and 18.60%were Klebsiella pneumoniae.Complication with diabetes mellitus,preoperative urethral catheterization and postoperative catheter indwelling time more than 3 days were the independent risk factors for the urinary tract infection in the BPH patients.CONCLUSION E.coli is the predominant species of pathogen causing the postoperative urinary tract infection in the BPH patients.It is necessary for the hospital to focus on the patients with diabetes mellitus,preoperative urethral catheterization and postoperative catheter indwelling time more than 3 days.