Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery, University of California, San Diego, 9500 Gilman Drive, MC 0633, La Jolla, CA, 92093-0633, USA.
Int Urogynecol J. 2020 Aug;31(8):1621-1626. doi: 10.1007/s00192-019-04061-1. Epub 2019 Jul 29.
Although postoperative urinary tract infections (UTIs) after urogynecologic surgery are a common adverse event, there is no standardized postoperative time period used to assess this outcome, and the uropathogens unique to this sub-population of patients have not been well described. Our objective is to describe the timing and uropathogens of postoperative UTI after urogynecologic surgery.
This retrospective study analyzed postoperative UTI occurring within 90 days following urogynecologic procedures from November 2013 to January 2018 at a single academic institution. Postoperative UTI was defined as any uropathogen growth from standard urine culture. Continuous variables were compared with independent samples t-test and categorical variables with chi-square with Bonferonni corrections as appropriate.
One hundred and two of 1085 (9.4%) patients experienced UTI; 63.7% occurred within 6 weeks and 78.4% within 8 weeks; 36.3% of UTIs occurred at a time period of 6 weeks to 90 days. Most commonly isolated uropathogens were Escherichia coli (47.8%) with an additional 11.2% extended-spectrum beta-lactamase (ESBL) Escherichia coli. Other bacteria included Enterococcus faecalis (10.4%), Klebsiella pneumoniae (9%), and one culture each for ESBL Klebsiella pneumoniae and vancomycin-resistant (VRE) Enterococcus faecium.
More than one third of UTIs after urogynecologic surgery occur between 6 weeks and 90 days postoperatively. A plateau of UTI incidence occurs at 8 weeks, a time period at which 78.4% of all UTIs were captured. Escherichia coli was the most commonly isolated uropathogen, and multi-drug-resistant bacteria were implicated in 12.8% of UTIs.
尽管妇科泌尿手术后的尿路感染（UTI）是一种常见的不良事件，但目前还没有用于评估该结果的标准化术后时间段，并且尚未很好地描述该亚组患者特有的尿路病原体。我们的目的是描述妇科泌尿手术后 UTI 的发生时间和病原体。
本回顾性研究分析了 2013 年 11 月至 2018 年 1 月在一家学术机构进行的妇科泌尿手术后 90 天内发生的术后 UTI。术后 UTI 定义为标准尿液培养中任何尿路病原体的生长。连续变量采用独立样本 t 检验进行比较，分类变量采用卡方检验（适当情况下采用 Bonferroni 校正）进行比较。
1085 例患者中有 102 例（9.4%）发生 UTI；63.7%发生在 6 周内，78.4%发生在 8 周内；36.3%的 UTI 发生在 6 周到 90 天的时间段内。最常见的分离病原体是大肠杆菌（47.8%），另有 11.2%为产超广谱β-内酰胺酶（ESBL）大肠杆菌。其他细菌包括粪肠球菌（10.4%）、肺炎克雷伯菌（9%）和 1 例 ESBL 肺炎克雷伯菌和万古霉素耐药（VRE）粪肠球菌。
妇科泌尿手术后超过三分之一的 UTI 发生在术后 6 周到 90 天。8 周时 UTI 发生率达到高峰，此时 78.4%的 UTI 均被捕获。大肠杆菌是最常见的分离病原体，12.8%的 UTI 涉及多药耐药菌。
