【摘要】：目的研究腎結(jié)石患者術(shù)后泌尿系感染的病原學(xué)特點(diǎn)及危險(xiǎn)因素。方法回顧性分析2013年5月-2016年5月醫(yī)院收治的494例行腎結(jié)石手術(shù)患者臨床資料,統(tǒng)計(jì)患者術(shù)后泌尿系統(tǒng)感染率,分析感染病原學(xué)特點(diǎn)及致病菌耐藥性,并分析相關(guān)危險(xiǎn)因素。結(jié)果 494例腎結(jié)石患者術(shù)后泌尿系統(tǒng)感染74例,感染率為14.98%,74例感染患者共檢出病原菌101株,其中革蘭陽(yáng)性菌31株,占30.69%,革蘭陰性菌63株,占62.38%,真菌7株,占6.93%;大腸埃希菌與肺炎克雷伯菌對(duì)頭孢吡肟、哌拉西林-他唑巴坦、亞胺培南及阿米卡星具有較強(qiáng)的耐藥性,對(duì)環(huán)丙沙星、磺胺甲VA唑/甲氧倫啶等的敏感性較高,糞腸球菌與屎腸球菌對(duì)青霉素、紅霉素、阿奇霉素等有較強(qiáng)的耐藥性,對(duì)萬(wàn)古霉素、亞胺培南及米諾環(huán)素等抗菌藥物的敏感性較高;年齡≥60歲、術(shù)前尿WBC≥2個(gè)/高倍視野及住院時(shí)間≥10d是腎結(jié)石患者術(shù)后發(fā)生泌尿系感染的相關(guān)危險(xiǎn)因素;Logistic回歸分析顯示年齡、術(shù)前尿WBC及住院時(shí)間為腎結(jié)石患者術(shù)后發(fā)生泌尿系感染的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論應(yīng)針對(duì)具有腎結(jié)石危險(xiǎn)因素患者,加強(qiáng)術(shù)后防治措施,以減少泌尿系統(tǒng)感染發(fā)生率。
[Abstract]:Objective to study the etiological characteristics and risk factors of urinary tract infection in patients with renal calculi after operation. Methods the clinical data of 494 patients with renal calculi treated in our hospital from May 2013 to May 2016 were analyzed retrospectively. The infection rate of urinary system, the pathogenic characteristics, the resistance of pathogenic bacteria and the risk factors were analyzed. Results there were 74 cases of urinary tract infection after operation in 494 patients with renal calculi, and the infection rate was 14.98%. A total of 101 strains of pathogenic bacteria were detected, including 31 strains of Gram-positive bacteria (30.69%), 63 strains of Gram-negative bacteria (62.38%) and 7 strains of fungi. Escherichia coli and Klebsiella pneumoniae were highly resistant to cefepime, piperacillin-tazobactam, imipenem and amikacin, and had higher sensitivity to ciprofloxacin, sulfamethoxazole / methoxyrenidine, etc. Enterococcus faecalis and Enterococcus faecium have strong resistance to penicillin, erythromycin and azithromycin, and have higher sensitivity to vancomycin, imipenem and minocycline. Preoperative urinary WBC 鈮，

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