前列腺增生患者术后尿路感染危险因素及外周血microRNA水平

Risk factors of postoperative urinary tract infection and peripheral blood microRNA levels in patients with prostatic hyperplasia

目的 探讨前列腺增生患者术后尿路感染的危险因素及外周血微小核糖核酸(microRNA)水平.方法 回顾性分析175例2018年1月-2022年5月于上饶市人民医院泌尿外科接受前列腺增生手术患者的临床资料,根据尿路感染情况分为感染组(32例)和未感染组(143例);收集患者临床资料,并分析病原菌特征及耐药性,采用Logistic回归分析前列腺增生患者术后尿路感染的危险因素.结果 32例前列腺增生术后患者共检出菌株38株,其中革兰阴性菌24株占63.16%,革兰阳性菌11株占28.95%,真菌3株占7.89%;大肠埃希菌、肺炎克雷伯菌对庆大霉素、磺胺甲噁唑/甲氧苄啶的耐药率>50.00%,而对亚胺培南均敏感;屎肠球菌、粪肠球菌对庆大霉素、青霉素、氨苄西林的耐药率>50.00%,而对万古霉素、呋喃妥因均敏感;多因素Logistic回归分析结果显示,miR-15a、miR-34b、miR-103是前列腺增生患者术后尿路感染的危险因素(OR=2.280、3.350、3.043,P<0.05).结论 前列腺增生术后尿路感染病原菌以革兰阴性菌为主,miR-15a、miR-34b和miR-103参与前列腺增生术后尿路感染过程,临床需合理选用抗菌药物,并根据尿路感染的危险因素和药敏结果制定预防对策,以降低尿路感染的发生.

OBJECTIVE To investigate the risk factors of postoperative urinary tract infection and peripheral blood microribonucleic acid(microRNA)levels in patients with prostatic hyperplasia.METHODS The clinical data of 175 patients who underwent prostate hyperplasia surgery in the Department of Urology,Shangrao People's Hospital from Jan.2018 to May 22 were retrospectively analyzed and divided into the infection group(32 cases)and the non-infection group(143 cases)according to whether urinary tract infection occurred.The clinical data of patients were collected,the characteristics and drug resistance of pathogenic bacteria were analyzed,and the risk factors of postoperative urinary tract infection in patients with benign prostatic hyperplasia were analyzed by multivariate logistic regression.RESULTS A total of 38 strains of pathogenic bacteria were detected in 32 postoperative patients with benign prostatic hyperplasia,of which 24 strains of gram-negative bacteria accounted for 63.16%,11 strains of gram-positive bacteria accounted for 28.95%,and 3 strains of fungi accounted for 7.89%.The resistance rate of Escherichia coli and Klebsiella pneumoniae to gentamicin and sulfamethoxazole-trimethoprim was more than 50.00%,while they were sensitive to imipenem;The resistant rate of Enterococcus and Enterococcus to gentamicin,penicillin and ampicillin were more than 50.oo%,while they were all sensitive to vancomycin and nitrofurantoin.Multivariate logistic regression analysis showed that high expression levels of miR-15a,miR-34b,and miR-103 in peripheral blood were independent risk factors for postoperative urinary tract infection in patients with prostatic hyperplasia(OR=2.280,3.350,3.043,P<0.05).CONCLUSION The pathogenic bacteria of postoperative urinary tract infections in patients with prostatic hyperplasia were mainly gram-negative bacteria.MiR-15a,miR-34b,and miR-103 were involved in the process of postoperative urinary tract infections in patients with prostatic hyperplasia.It is necessary to choose antibiotics rationalized in clinical practice,and develop preventive strategies based on the risk factors and drug sensitivity results of urinary tract infections to reduce the occurrence of urinary tractinfections.