经尿道前列腺切除术后患者泌尿系感染病原菌分布及危险因素分析

发布时间：2018-03-02 18:19

  本文选题：经尿道前列腺切除术　切入点：泌尿系统感染　出处：《中华医院感染学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的探讨经尿道前列腺切除术(TURP)患者术后泌尿系感染的病原菌分布及药敏特征,并分析感染的危险因素及护理对策,根据相关因素制定预防和控制措施,以期降低感染率。方法选取2011年4月-2016年4月480例良性前列腺增生症(BPH)并接受TURP治疗的患者纳入研究,分析患者泌尿系统感染率、耐药菌分布、药敏特征及相关危险因素。结果 480例BPH患者术后发生泌尿系统感染76例,感染率为15.8%;76例患者标本中共分离出病原菌80株,其中革兰阴性菌44株,占55.0%,革兰阳性菌34株,占42.5%,真菌2株,占2.5%;革兰阴性菌中大肠埃希菌对氨苄西林耐药率最高为88.9%,铜绿假单胞菌对头孢唑林耐药率最高为50.0%,二者均对亚胺培南敏感;革兰阳性菌中表皮葡萄球菌对青霉素的耐药率最高为60%,对万古霉素敏感;患者年龄≥60岁、合并糖尿病、合并高血压、术前导尿、前列腺≥30g、手术时间≥1h、术后导尿管留置时间3d、术前应用抗菌药物是TURP术后发生泌尿系感染的相关因素;多因素Logistic回归分析显示合并糖尿病(OR=2.412,95%CI:0.378~8.207)、术前未应用抗菌药物(OR=3.374,95%CI:1.977~16.884)、术前导尿(OR=3.579,95%CI:0.884~9.693)以及术后导尿管留置时间3d(OR=2.864,95%CI:1.413~10.442)是TURP术后发生泌尿系感染的独立危险因素(P0.05)。结论应针对TURP术后发生泌尿系感染的高危因素,加强基础护理及专科护理,最大程度降低感染率。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug sensitivity in patients with urinary tract infection after transurethral prostatectomy (TURP), analyze the risk factors of infection and nursing countermeasures, and formulate prevention and control measures according to the relevant factors. Methods from April 2011 to April 2016, 480 patients with benign prostatic hyperplasia (BPH) treated with TURP were included in the study, and the urinary system infection rate and the distribution of drug-resistant bacteria were analyzed. Results there were 76 cases of urinary tract infection in 480 patients with BPH, and the infection rate was 15.876 cases. A total of 80 strains of pathogenic bacteria were isolated, among which 44 strains were Gram-negative bacteria (55.0%), 34 strains were Gram-positive bacteria. Among Gram-negative bacteria, Escherichia coli had the highest resistance rate to ampicillin, while Pseudomonas aeruginosa to cefazolin had the highest resistance rate to cefazolin, both of which were sensitive to imipenem. Among Gram-positive bacteria, Staphylococcus epidermidis had the highest resistance to penicillin and was sensitive to vancomycin. Prostatic gland 鈮，

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