关键词: 膀胱癌, 尿路感染, 病原菌, 药敏分析

Abstract:

Objective　To retrospectively analyze the pathogenic bacteria and their drug sensitivities of urinary tract infection after resection of bladder cancer, and to provide references for clinicians to select antibiotics. Methods　From January 2017 to September 2021, 277 patients with urinary tract infection after resection of bladder tumor in Tengzhou Central People's Hospital Affiliated to Xuzhou Medical University were selected, including 126 males and 151 females, with an age of (66.7±8.7) years old, and their midstream urine samples were collected for routine culture. The identification and drug sensitivity test were carried out on pathogenic bacteria. Results　The main pathogens of urinary tract infection after resection of bladder tumor were Gram-negative bacilli [77.62% (215/277)], mainly Escherichia coli [42.24% (117/277)] and Klebsiella pneumoniae [15.16% (42/277)]; the second was Gram-positive cocci [21.30% (59/277)], mainly Enterococcus faecalis D group [8.66% (24/277)] and Streptococcus agalactiae B group [4.69% (13/277)]; fungi accounted for 1.08% (3/277). The drug-sensitive test results showed that the more sensitive antibiotics of Escherichia coli and Klebsiella pneumoniae were mainly ertapenem, imipenem, and meropenem (all >96%), and the antibiotics with high resistance rate were mainly ampicillin, cefazolin, and ciprofloxacin (all >60%); Enterococcus faecalis D group and Streptococcus agalactiae B group showed higher sensitivity to ampicillin, linezolid, penicillin, daptomycin, nitrofurantoin, tigecycline, teicoplanin, and vancomycin (all >94%), Enterococcus faecalis D group was more resistant to clindamycin, tetracycline, and erythromycin (all >66%), and Streptococcus agalactiae B group was more resistant to clindamycin, erythromycin, levofloxacin, and moxifloxacin (all >80%). Conclusions　The main pathogens of urinary tract infection after resection of bladder cancer are gram-negative bacilli, mainly Escherichia colicancer and Klebsiella pneumoniae, and the Gram-positive cocci are mainly Enterococcus faecalis D group and Streptococcus agalactiae B group. The resistance rates of pathogenic bacteria to some antibiotics are high, so clinicians should pay attention to monitoring and drug sensitivity test results of pathogenic bacteria, and apply antibiotics rationally.

Key words: Bladder cancer, Urinary tract infection, Pathogens, Drug sensitivity analysis