Characteristic and drug choice of Urology surgical postoperative infection
LI Lixia1 LI Yongyang2▲
1.Department of Pharmaceutical, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China;
2.Department of General surgery, East Campus of Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 201306, China
Abstract:Objective To analyze the characteristics and trends of urology surgical postoperative infection, in order to provide references for clinical pharmacists. Methods From January 2010 to December 2015, in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 228 urology surgical postoperative infection patients with clinical pharmacists were consulted were analyzed retrospectively. According to these diseases categories, they were divided into four groups, kidney stone group (n = 90), ureteral calculus group (n = 35), kidney and ureteral calculus group (n = 21) and other disease group (n = 82). The infection sites, bacterial categories, anti-infection treatment schedules, and treatment outcome were analyzed individually. Results The infection sites were mainly urinary tract, blood system or lungs. Except for the blood system infection, the difference of incidence rate of the other infection sites among the four groups was statistically significant (P < 0.01). E. coli had the highest detection rate, and the difference of its infection rate among four groups was statistically significant (P < 0.01). Candida albicans had the second highest infection rate, and Enterococcus had the third highest infection rate. Imipenem had the highest usage rate, and Piperacillin-Tazobactam had the second highest usage rate. 47% patients were cured, 50.9% patients were improved. the difference of recovery rate among the four groups was statistically significant (P < 0.05). Conclusion Clinical pharmacists analyze the common infection sites, pathogens and effective anti-infection treatment schedules, and take an active role in curing infection and reducing infection mortality rate.
李莉霞1 李永洋2▲. 泌尿外科术后感染特点与药物选择[J]. 中国医药导报, 2017, 14(17): 134-137.
LI Lixia1 LI Yongyang2▲. Characteristic and drug choice of Urology surgical postoperative infection. 中国医药导报, 2017, 14(17): 134-137.
[1] Walton-Diaz A,Vinay JI,Barahona J,et al. Concordance of renal stone culture: PMUC,RPUC,RSC and post-PCNL sepsis-a non-randomized prospective observation cohort study [J]. Int Urol Nephrol, 2017,49(1):31-35.
[2] Yang T,Liu S,Hu J,et al. The evaluation of risk factors for postoperative infectious complications after percutaneous nephrolithotomy [J]. Biomed Res Int,2017,2017:4832051.
[3] Michel MS,Trojan L,Rassweiler JJ,et al. Complications in percutaneous nephrolithotomy [J]. Ero Urol,2007,51(4):899-906.
[4] Osman M,Wendt-Nordahl G,Heger K,et al. Percutaneous nephrolithotomy with utrasonograghy-guided renal access:experience from over 300 cases [J]. BJU Int,2005,96(6):875-878.
[5] Mariappan P,Smith G,Moussa SA,et al. One week of ciprof-loxacin before percutaneous nephrolithotomy significantly reduces upper tract infection and urosepsis:a prospective controlled study [J]. BJU Int,2006,98(5):1075-1079.
[6] Draga RO,Kok ET,Sorel MR,et al. Percutaneotm nephrolithotomyt factors associated with fever after the first postoperative day and systemic inflammatory response syndrome [J]. J Endourol,2009 ,23(6):921-927.
[7] 向松涛,王叔声,甘澍,等.经皮肾镜取石术后尿源性脓毒症休克的诊治特点分析[J].中华泌尿外科杂志,2010, 31(8):520-523.
[8] 谭一伟,张冠,刘乃波,等.输尿管镜钬激光碎石术治疗输尿管结石[J].临床泌尿外科杂志,2009,24(5):363-367.
[9] 郑会忠.输尿管镜钬激光碎石术后泌尿系统感染的细菌分布及药敏分析[J].重庆医学,2014,43(7):850-852.
[10] Togo Y,Tanaka S,Kanematsu A,et al. Antimicrobial prophylaxis to prevent perioperative infection in urological surgery:a multicenter study [J]. J Infect Chemother,2013, 19(6):1093-1101.
[11] 王大伟,盛畅,鲁军.肾结石合并输尿管结石的微创治疗[J].中国微创外科杂志,2011,11(3):222-224.
[12] 孙婷婷,胡昭宇,曹雁,等.泌尿系感染常见病原菌的分布及耐药性分析[J].中国微生态学杂志,2013,25(9):1085-1088.
[13] Magiorakos AP,Srinivasan A,Carey RB,et al. Multidrug-resistant,extensively drug-resistant and pandrug-resistant bacteria:an international expert proposal for interim standard definitions for acquired resistance [J]. Clin Microbiol Infect,2012,18(3):268-281.
[14] Linhares I,Raposo T,Rodrigues A,et al. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections:A ten-year surveillance study(2000-2009)[J]. BMC Infect Dis,2013,13(1):19 .
[15] Collins AJ,Foley RN,Chavers B,et al. United States Renal Data System 2011 Annual Data Report:Atlas of chronic kidney disease & end-stage renal disease in the United States [J]. Am J Kidney Dis,2012,59(Suppl 1):e1-e420.
[16] Dellinger RP,Levy MM,Carlet JM,et al. Surviving Sepsis Campaign:international guidelines for management of severe sepsis and septic shock:2008 [J]. Crit Care Med,2008,36(1):296-327.
[17] Rivera M,Viers B,Cockerill P,et al. Pre- and postoperative predictors of infection-related complications in patients undergoing percutaneous nephrolithotomy [J]. J Endourol,2016,30(9):982-986.
[18] Ramaraju K,Paranjothi AK,Namperumalsamy DB,et al. Predictors of systemic inflammatory response syndrome following percutaneous nephrolithotomy [J]. Urol Ann,2016,8(4):449-453.
[19] 高旭,许传亮,陈策,等.输尿管镜下钬激光碎石术后重症感染诊治体会[J].中华泌尿外科杂志,2005,26(1):33-35.
[20] 卢瑶华,吴志坚.输尿管镜碎石术后重症感染的诊治研究[J].临床泌尿外科杂志,2008,23(2):150-151.