输尿管结石患者术后尿路感染的病原菌特点及易感因素分析

Pathogens characteristics and related factors of postoperative urinary tract infection in patients with ureteral calculi

目的:探讨输尿管结石患者术后尿路感染的病原菌特点及易感因素。方法:回顾性分析2019年1月至2020年12月许昌市人民医院收治的254例输尿管结石患者的临床资料,根据尿路感染发生情况将患者分为感染组(24例)和非感染组(230例)。对感染组患者尿液进行病原菌培养,分析影响输尿管结石患者术后尿路感染的危险因素。结果:254例输尿管结石患者术后尿路感染发生率为9.45%(24/254)。24例尿路感染患者共检出病原菌24株,均为单一感染,其中革兰阴性菌占62.50%(15/24),以大肠埃希菌为主;革兰阳性菌占33.33%(8/24),以粪肠球菌为主;共分离真菌1株(4.17%)。单因素分析结果显示,年龄、合并糖尿病、术前合并尿路感染、结石长径、手术时间、留置导尿管时间、住院时间、结石数量是影响输尿管结石患者术后尿路感染的危险因素(P<0.05)。多因素Logisitic回归分析发现,年龄≥60岁、合并糖尿病、手术时间≥120 min、术前合并尿路感染、结石长径≥3 cm是响输尿管结石患者术后尿路感染的独立危险因素(P<0.05)。结论:年龄≥60岁、合并糖尿病、手术时间≥120 min、术前合并尿路感染、结石长径≥3 cm是输尿管结石患者术后发生尿路感染的易感因素,尿液病原菌培养以革兰阴性菌为主。

Objective To investigate the pathogens characteristics and related factors of postoperative urinary tract infection(UTI)in patients with ureteral calculi.Methods The clinical data of 254 patients with ureteral calculi admitted to Xuchang People’s Hospital from January 2019 to December 2020 were retrospectively analyzed.According to occurrence of UTI,they were divided into infection group(24 cases)and non-infection group(230 cases).The pathogens culture of urine from infection group was conducted.The risk factors of postoperative UTI in patients with ureteral calculi were analyzed.Results The incidence of postoperative UTI in the 254 patients with ureteral calculi was 9.45%(24/254).Among the 24 UTI patients,there were 24 strains of pathogens,all of them were single infection.Among them,Gram-negative bacteria accounted for 62.50%(15/24),mainly infected with Escherichia coli;Gram-positive bacteria accounted for 33.33%(8/24),mainly infected with Enterococcus faecalis;and there was 1 strain of fungus,accounting for 4.17%.Univariate analysis showed that age,diabetes mellitus,preoperative UTI,diameter of calculi,operation time,indwelling catheter time,hospitalization time and number of calculi were the risk factors of postoperative UTI in patients with ureteral calculi(P<0.05).Multivariate Logistic regression analysis showed that age not younger than 60 years old,diabetes mellitus,operation time not shorter than 120 min,preoperative UTI and diameter of calculi not shorter than 3 cm were independent risk factors of postoperative UTI(P<0.05).Conclusions Age equal or older than 60 years old,diabetes mellitus,operation time equal or longer than 120 min,preoperative UTI,and diameter of calculi not shorter than 3 cm are risk factors of postoperative UTI in patients with ureteral calculi.The main pathogens in urine culture are Gram-negative bacteria.