Department of Urology, The First Affiliated Hospital With Nanjing Medical University (Jiangsu Province Hospital), Nanjing, China.
Department of Nursing, The First Affiliated Hospital With Nanjing Medical University (Jiangsu Province Hospital), Nanjing, China.
Biol Res Nurs. 2024 Jul;26(3):361-367. doi: 10.1177/10998004241226948. Epub 2024 Jan 9.
Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy.
A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients.
The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with having the highest proportion.
Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.
术后尿路感染是一种常见的并发症，不仅显著延长了患者的住院时间，增加了患者的经济负担，还影响了他们的生活质量和预后。本研究旨在探讨膀胱癌患者根治性膀胱切除术后行皮输尿管造口术后尿路感染的危险因素和病原菌分布。
回顾性分析 2018 年 11 月至 2022 年 10 月我院 137 例行根治性膀胱切除术后皮输尿管造口术的膀胱癌患者资料。采用单因素和多因素 logistic 回归分析探讨术后尿路感染的危险因素及感染患者病原菌分布。
单因素和多因素分析结果均证实，年龄、造口知识掌握程度、输尿管支架管更换频率、输尿管支架管移位、输尿管支架管外端尿液浸泡、造口袋更换间隔是膀胱癌患者根治性膀胱切除术后和皮输尿管造口术后尿路感染的独立危险因素。52 例感染患者共分离出 55 株病原菌，以革兰阴性菌为主（34 株，61.8%），其中以大肠埃希菌检出率最高。
根治性膀胱切除术后和皮输尿管造口术后尿路感染主要涉及革兰阴性菌，与膀胱癌患者的年龄、护理教育水平、输尿管支架管和造口袋使用时间以及尿液引流受损等因素有关。
