良性前列腺增生TURP术后尿路感染病原菌特征、耐药性及与CYP1A2基因多态性的关系研究

Study on pathogenic bacteria characteristics and drug resistance of urinary tract infection after transurethral resection of prostate for benign prostatic hyperplasia and the relationship with cytochrome P450 1A2 gene polymorphism

目的研究良性前列腺增生(BPH)经尿道前列腺切除术(TURP)术后尿路感染病原菌特征、耐药性及与细胞色素P450酶1A2(CYP1A2)基因多态性的关系。方法选取2016年1月至2020年12月浙江省玉环市人民医院收治的234例行TURP治疗的BPH患者作为研究对象。根据术后有无尿路感染分为感染组(n=36)和非感染组(n=198),分析尿路感染病原菌和耐药性,检测CYP1A2基因多态性,采用Logistic回归分析CYP1A2基因多态性位点与TURP术后尿路感染的关系。结果36例TURP术后尿路感染患者共培养出病原菌42株,革兰氏阴性菌占61.90%,革兰氏阳性菌占28.57%,真菌占7.14%,其中主要以大肠埃希菌为主,占35.71%;大肠埃希菌对氨苄西林、环丙沙星、左氧氟沙星、庆大霉素的耐药率较高,均>60.00%。感染组CYP1A2基因Rs762551位点AA基因频率及A等位基因频率高于非感染组,CC基因频率及C等位基因频率低于非感染组(P<0.05);两组CA基因频率比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,CYP1A2基因Rs762551位点AA基因型(OR=3.991,95%CI:1.251~12.735)发生TURP术后尿路感染的风险显著升高(P<0.05)。结论BPH患者TURP术后尿路感染以大肠埃希菌为主,且CYP1A2基因Rs762551位点AA基因型可增加TURP术后尿路感染的风险。

Objective To study the pathogenic bacteria characteristics and drug resistance of urinary tract infection after transurethral resection of prostate(TURP)for benign prostatic hyperplasia(BPH),and the relationship with cytochrome P4501A2(CYP1A2)gene polymorphism.Methods A total of 234 patients with BPH who underwent TURP from January 2016 to December 2020 in Yuhuan People′s Hospital,Zhejiang Province were selected,and divided into the infection group(n=36)and the non⁃infection group(n=198)according to the presence or absence of urinary tract infection after TURP.The distribution and drug resistance of pathogenic bacteria of urinary tract infection were analyzed.CYP1A2 gene polymorphism was detected.Logistic regression was used to analyze the relationship between polymorphism of CYP1A2 gene and urinary tract infection after TURP.Results A total of 42 pathogenic bacteria strains were cultured in 36 patients with urinary tract infection after TURP,including Gram⁃negative bacteria(61.90%),Gram⁃positive bacteria(28.57%)and fungi(7.14%).Escherichia coli was the main pathogenic bacteria,accounting for 35.71%.The resistance rates of Escherichia coli to ampicillin,ciprofloxacin,levofloxacin and gentamicin were higher than 60.00%.The AA gene frequency and A allele frequency of CYP1A2 gene rs762551 in the infection group were higher than those in the non⁃infection group,and CC gene frequency and C allele frequency were lower than those in the non⁃infection group(P<0.05).There was no significant difference in CA gene frequency between the two groups(P>0.05).Logistic regression analysis found that patients with AA genotype(OR=3.991,95%CI:1.251⁃12.735)of CYP1A2 gene rs762551 had a high risk of urinary tract infection after TURP(P<0.05).Conclusions Escherichia coli is the main pathogenic bacteria of urinary tract infection in patients with BPH after TURP.AA genotype of CYP1A2 gene rs762551 will increase the risk of urinary tract infection after TURP。