前列腺增生患者尿流动力学检查后尿路感染发生率及危险因素分析

The incidence and risk factors of urinary tract infection in patients with prostatic hyperplasia following invasive urodynamic investigation

目的探讨前列腺增生患者完成尿流动力学检查后尿路感染发生率及相关危险因素。方法选取2012年1月至2017年6月在我院行尿流动力学检查的前列腺增生患者540例,其尿流动力学检查前尿液分析白细胞≤18个/μl且中段尿培养阴性;检查完成后24～48 h内收集尿液行尿液分析及尿培养,尿液分析白细胞>18个/μl及中段尿培养阳性代表发生尿路感染。对入选患者的特征及相关尿流动力学参数进行分析对比。结果 540例前列腺增生患者完成尿流动力学检查,其中45例患者发生尿路感染,发生率为8.33%,其相关危险因素为糖尿病、膀胱出口梗阻、膀胱残余尿量、前列腺体积和最大尿流率及平均尿流率,最常见的致病菌为大肠埃希氏菌及肠球菌(51%,20%)。结论患者合并糖尿病、膀胱出口梗阻、残余尿量越多、前列腺体积越大、最大尿流率越低、平均尿流率越低尿流动力学检查后尿路感染发生率越高,这部分患者适当接受抗生素治疗可能获益,。

Objective To investigate the incidence and related risk factors of urinary tract infection in patients with prostatic hyperplasia following urodynamic study.Methods A total of 540 patients with prostatic hyperplasia,who underwent urodynamic study in our hospital from January 2012 to June 2017 were recruited in this study.Before urodynamic study,urinalysis and bacterial culture was performed.Patients with negative results were selected for urodynamic study.Between 24 h and 48 h after the examination,urinalysis and urine culture were performed again to determine the incidence of urinary tract infection.The positive urine culture imply urinary tract infection.The patients'baseline characteristics and urodynamic parameters were analyzed.Results Among the 540 patients,urinary infection was found in 45 cases after the examination,the incidence was 8.33%.Comorbidity with diabetes,bladder outlet obstruction,post void residual(PVR),volume of prostate(Vp),maximal flow rate(Qmax)and average flow rate(Qav)were found to be the independent risk factors for urinary tract infection following urodynamic study.The most common pathogens were Escherichia coli and Enterococcus(51%,20%).Conclusion Patients with diabetes mellitus,bladder outlet obstruction,high residual urine volume,large prostate volume,low maximum urinary flow rate,low average urinary flow rate,may need to be treated with prophylactic antibiotics to prevent postoperative urinary tract infection.It may be beneficial to start a short course of the prophylactic antibiotics treatment following urodynamic study.