前列腺增生症术后尿路感染病原菌及其耐药性和CYP1A2基因多态性

Distribution and drug resistance of pathogens isolated from patients with benign prostatic hyperplasia with postoperative urinary tract infection and CYP1A2 gene polymorphism

目的 分析前列腺增生症术后患者尿路感染的病原菌检测结果、耐药性及CYP1A2基因多态性。方法 以2019年1月-2022年5月山东省泰山医院收治的前列腺增生症术后患者206例为研究对象,根据患者术后是否发生尿路感染将其分为感染组(63例)和未感染组(143例)。比较两组一般资料及临床特点、CYP1A2基因多态性,统计前列腺增生症术后尿路感染患者感染病原菌分布情况及其耐药性。结果 感染组合并糖尿病患者占比高于未感染组,住院时间长于未感染组(P<0.05);感染组等位基因A占比和基因型AA占比均高于未感染组;63例前列腺增生症术后尿路感染患者共分离出72株病原菌,其中革兰阴性菌检出41株,占比为56.94%,检出率最高的病原菌为大肠埃希菌,占比为27.78%;革兰阳性菌检出31株,占比为43.06%,检出率最高的病原菌为屎肠球菌,占比为18.06%;大肠埃希菌对氨苄西林耐药性较高,耐药株数为17株,对头孢西丁、阿米卡星、哌拉西林/他唑巴坦、头孢吡肟、呋喃妥因、头孢哌酮、亚胺培南较敏感;屎肠球菌对青霉素G耐药性较高,耐药株数为11株,对呋喃妥因、万古霉素较敏感。结论 前列腺增生症术后尿路感染患者具有合并糖尿病患者占比高、住院时间长的特点,其主要感染病原菌种类为大肠埃希菌、屎肠球菌,选择敏感度较高的抗菌药物对患者进行治疗有助于尽快控制患者病情。

OBJECTIVE To analyze the detection results,drug resistance and CYP1A2 gene polymorphism of pathogens causing urinary tract infection in patients with benign prostatic hyperplasia after operation.METHODS From Jan 2019 to May 2022,206 cases of postoperative patients with benign prostatic hyperplasia in Shandong Taishan Hospital were enrolled as the research subject,and they were divided into the infected group(63 cases)and the uninfected group(143 cases)according to whether the urinary tract infection occurred in patients after operation.The general data,clinical features and CYP1A2 gene polymorphism between the two groups were compared,and the distribution and drug resistance of pathogenic bacteria in patients with urinary tract infection after prostatectomy were analyzed.RESULTS The proportion of diabetes mellitus patients combined with infection was higher than that of the uninfected group,and the hospital stay was longer than that in the uninfected group(P<O.05).The percentage of allele A and genotype AA in the infected group was higher than that in the uninfected group(P<0.05).Seventy-two pathogenic bacteria were isolated from 63 patients with urinary tract infection after prostatectomy,of which 41 were gram-negative bacteria,accounting for 56.94%.The highest detection rate was Escherichia coli,accounting for 27.78%.Thirty-one strains of gram-positive bacteria were detected,accounting for 43.06%,and Enterococcus faecium accounted for 18.06%.E.coli had high resistance to ampicillin,and.17 drug-resistant strains were detected.They were sensitive to cefoxitin,amicacin,piperacillin/tazobactam,cefepime,furanotoin,cefoperazone and imipenem.Enterococcus faecium was highly drug-resistant to penicillin G,and 11 drug-resistant strains were detected.It was sensitive to furantoin and vancomycin.CONCLUSION Postoperative urinary tract infection patients with prostatic hyperplasia were characterized by a high proportion of patients with diabetes and a long hospital stay.The main pathogenic bacteria are E.coli and Enterococcus faecium.The highly sensitive antibiotics administered is helpful to control the progression of the disease in patients as soon as possible.