改良留置导尿管相关尿路感染病原菌及感染危险因素研究

Study of the pathogenic bacteria and risk factors for patients with modified indwelling catheter-associated urinary tract infection

目的研究改良留置导尿管相关尿路感染患者病原菌的分布情况,分析改良留置导尿管患者尿路感染的危险因素。方法纳入2018年3月至2020年3月邯郸市第一医院收治的168例改良留置导尿管患者作为研究对象,观察所有患者尿路感染和病原菌分布情况。将发生尿路感染和未发生尿路感染的患者收集资料并进行对比,差异有统计学意义项目代入Logistic回归方程计算,分析改良留置导尿管患者发生尿路感染的危险因素。结果168例改良留置导尿管患者中有49例患者发生尿路感染,发生率为29.17%。共检出病原菌84株。其中革兰阴性杆菌50株(59.52%),革兰阳性球菌24株(28.57%),真菌10株(11.90%)。发生尿路感染和未发生尿路感染患者在年龄、住院时间、留置导尿管时间、糖尿病、肾结石、低蛋白血症以及抗菌药物使用种类上对比差异均有统计学意义(P<0.05)。将上述项目代入Logistic回归方程计算发现,年龄≥60岁、住院时间≥21 d、留置导尿管时间≥13 d、合并糖尿病、合并肾结石、合并低蛋白血症以及尿路感染前抗菌药物使用种类≥3种均是改良留置导尿管患者发生尿路感染的危险因素。结论改良留置导尿管患者相关尿路感染发生率较高,主要病原菌为革兰阴性杆菌。患者发生尿路感染的危险因素较多,临床应针对性给予干预措施,降低尿路感染的发生率。

Objective To study the pathogenic bacteria distribution conditions and its risk factors for patients with modified indwelling catheter-associated urinary tract infection.Methods 168 patients received the modified indwelling catheter from March 2018 to March 2020 in the First Hospital of Handan were selected as research subjects.The urinary tract infection and pathogenic bacteria distribution conditions were observed.Clinical data about infection cases and non-infection cases were acquired.Logistic regression equation was used to analyze the risk factors of medified indwelling catheter-associated urinary tract infection.Results Among 168 cases,49 patients were occurred with urinary tract infection(29.17%),a total of 84 pathogenic bacteria strains were detected,including 50 gram-negative bacilli strains(59.52%),24 gram-positive coccus strains(28.57%)and 10 fungus strains(11.90%).There were significant differences in age,hospital stay,time of indwelling catheter,diabetes,kidney stones,hypoproteinemia and the types of antibiotics used between patients with urinary tract infection and without urinary tract infection(P<0.05).Logistic regression equation results indicated that the risk factors of urinary tract infection included the age≥60 years old,hospital stays≥21 d,indwelling time≥13 d,hypoproteinemia and types of antibacterial agents used≥3.Conclusion Patients with modified indwelling catheter are prone to have urinary tract infection,of which the major pathogenic bacteria are gram-negative bacilli.There are multiple risk factors for urinary tract infection.Therefore,the specific intervention measures can reduce the incidence of urinary tract infection.