中西医结合治疗泌尿外科患者常见尿路感染情况及危险因素的回归分析

Regression analysis of risk factors of traditional Chinese medicine combined with Western medicine in the treatment of urological infection

目的调查本院近年来院内尿路感染病原学特点、耐药情况及引起尿路感染的相关危险因素分析。方法选择于2014年2月至2015年2月就诊于本院泌尿外科的患者200例,经显微镜检及尿培养确定为尿路感染,分析患者尿路感染的病原菌分布及临床耐药情况。同时匹配200例非尿路感染的泌尿外科患者,采用多元逐步Logistic回归法分析影响尿路感染的因素。结果本院泌尿外科患者尿路感染常见的病原学分布以大肠埃希菌、铜绿假单胞菌和粪球菌为主,检出率分别高达42.09%、11.87%和17.63%,男女患者中检出菌所占的比例基本一致;且分离菌株耐药性普遍较高,主要菌株对氨苄西林和克林霉素、磺胺甲恶唑就有较高的耐药性。经过单因素方差分析得出与尿路感染相关的变量有8个,P值均<0.18。对这8个危险因素采用Logistic回归方法筛选出的与尿路感染相关的危险因素有4个,分别为性别、侵入性操作、留置导尿管时间及抗生素使用。结论本院尿路感染常见的病原菌为大肠埃希菌、铜绿假单胞菌和粪球菌。影响尿路感染的危险因素主要有性别、侵入性操作、留置导尿管时间及抗生素使用,因此在临床治疗过程中应采取相应措施予以应对。

Objective To investigate the etiologcial characteristics ,drug resistance and risk factors of urinary tract infection .Methods A total of 200 patients treated in the urological department during Feb .2014 and Feb . 2015 were enrolled .Microscopy and urine culture confirmed urinary tract infection .The distribution of pathogenic bacteria and drug resistance were analyzed .At the same time ,200 cases of urological patients without urinary tract infection were enrolled as controls .Multiple stepwise Logistic regression was used to analyze the influencing factors of urinary tract infection .Results The major pathogens were e .coli ,pseudomonas aeruginosa and fecal bacteria . The detection rate was as high as 42 .09% ,11 .87% and 17 .63% ,respectively .The detection rate was almost the same among male and female patients .Isolates had high resistance ,especially against ampicillin ,clindamycin ,and sulfame‐thoxazole .Single factor variance analysis showed 8 variables associated with urinary tract infection ,all P〈0.18 .Lo‐gistic regression method selected 4 from them ,including gender ,invasive operation ,the time of indwelling urinary catheters ,and antibiotic use .Conclusion The common pathogenic bacteria for urinary tract infection include e .co‐li ,pseudomonas aeruginosa and fecal bacteria .The influencing factors are sex ,invasive operation ,the time of indwell‐ing urinary catheters ,and antibiotic use .Proper measures should be taken to deal with these influencing factors .