术前大肠杆菌培养阳性对尿道狭窄成形术后感染及发热的影响

潘昊; 刘彧; 金熙; 李虹; 王坤杰

doi:10.16016/j.2097-0927.202311096

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术前大肠杆菌培养阳性对尿道狭窄成形术后感染及发热的影响

临床医学 | 更新时间：2026-01-09

- 术前大肠杆菌培养阳性对尿道狭窄成形术后感染及发热的影响
- Impact of positive preoperative E. coli infection on surgical site infection and postoperative fever after urethral strictoplasty
- 陆军军医大学学报 2024年46卷第3期页码：277-282
- 作者机构：
  
  610041 成都，四川大学华西医院泌尿外科
- 作者简介：
  
  [ 王坤杰，E-mail：wangkj@scu.edu.cn WANG Kunjie, E-mail: wangkj@scu.edu.cn
- 基金信息：
- DOI：10.16016/j.2097-0927.202311096
  中图分类号： R181.32;R378.21;R693.2
- 收稿：2023-11-20，
  
  修回：2023-12-12，
  
  纸质出版：2024-02-15
- 稿件说明：
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潘昊, 刘彧, 金熙, 等. 术前大肠杆菌培养阳性对尿道狭窄成形术后感染及发热的影响[J]. 陆军军医大学学报, 2024,46(3):277-282.

Hao PAN, Yu LIU, Xi JIN, et al. Impact of positive preoperative E. coli infection on surgical site infection and postoperative fever after urethral strictoplasty[J]. Journal of Army Medical University, 2024, 46(3): 277-282.
潘昊, 刘彧, 金熙, 等. 术前大肠杆菌培养阳性对尿道狭窄成形术后感染及发热的影响[J]. 陆军军医大学学报, 2024,46(3):277-282. DOI： 10.16016/j.2097-0927.202311096.

Hao PAN, Yu LIU, Xi JIN, et al. Impact of positive preoperative E. coli infection on surgical site infection and postoperative fever after urethral strictoplasty[J]. Journal of Army Medical University, 2024, 46(3): 277-282. DOI： 10.16016/j.2097-0927.202311096.

摘要

目的

探究大肠杆菌相较其他病原体感染，是否增加尿道成形术后的手术部位感染以及术后发热。

方法

采用回顾性队列研究的方式，纳入华西医院泌尿外科2011-2019年接受尿道狭窄段切除和端端吻合术来治疗尿道球部或后尿道狭窄的患者共506例，按术后是否发生手术部位感染(surgical site infection

SSI)和术后发热(postoperative fever

POF)分别分为SSI组(19例)和非SSI组(487例)，POF组(61例)和非POF组(445例)；采用多元Logistic回归分析与LASSO算法筛选潜在的危险因素；按照术前尿培养结果将患者分为大肠杆菌感染组(80例)和其他病原体感染组(222例)，通过倾向评分匹配减少潜在偏倚后(匹配后大肠杆菌组：48例；其他病原体组：192例)，比较大肠杆菌感染组与其他病原体感染组在手术部位感染和术后发热方面的差异。

结果

在多元Logistic回归分析与LASSO算法中，术前尿培养阳性是预测手术部位感染(

=0.012)和术后发热(

＜0.01)的独立危险因素，在302例术前尿培养阳性的患者中，大肠杆菌感染比例位居第一(26.5%)。倾向评分匹配处理后，大肠杆菌组与其他病原体组的手术部位感染的比例分别为29.2%和2.1%(

＜0.01)。与其他病原体感染组相比，大肠杆菌感染组的术后发热比例也较高(27.1%

13.5%

=0.02)。

结论

与其他病原体感染相比，术前大肠杆菌感染会增加尿道成形术后的手术部位感染、术后发热风险。

Abstract

Objective

To investigate whether

E. coli

infection increases surgical site infection and postoperative fever in comparison

with other pathogens.

Methods

A retrospective cohort study was conducted on 506 patients who underwent urethral segment resection and end anastomosis for the bulb or posterior urethral stenosis in our department during 2011 and 2019. According to occurrence of postoperative surgical site infection (SSI) or postoperative fever (POF)

they were divided into SSI group (

=19) and non-SSI group (

=487)

as well as POF group (

=61) and non-POF group (

=445 patients) respectively. Multivariate logistic regression analysis and LASSO algorithm were used to screen the potential risk factors. According to the results of positive preoperative urine culture in 302 patients

they were subsequently divided into

E. coli

infection group (

=80) and other pathogen infection group (

=222)

and after reducing potential bias with propensity score matching

finally 48 patients were assigned into

E. coli

infection group

and 192 into other pathogen infection groups. The differences in occurrences of SSI and POF were compared between the above 2 groups of patients.

Results

Multivariate logistic regression analysis and LASSO algorithm revealed that positive preoperative urine culture was an independent risk factor for predicting SSI (

=0.012) and POF (

0.01). Among the 302 patients with positive results in preoperative urine culture

E. coli

infections was in the first rank

accounting for 26.5%. After propensity score matched treatment

the incidence of SSI in the

E. coli

group and other pathogen groups was 29.2% and 2.1%

respectively (

0.01). The incidence of POF was also higher in the

E. coli

infection group than the other pathogen infection group (27.1%

13.5%

=0.02).

Conclusion

Preoperative

E. coli

infection may increase the risk of SSI and POF after urethroplasty when compared with other pathogen infections.

关键词

Keywords

references

SANTUCCI R A, JOYCE G F, WISE M. Male urethral stricture disease[J]. J Urol, 2007, 177(5): 1667-1674. DOI: 10.1016/j.juro.2007.01.041.

MUNDY A R, ANDRICH D E. Urethral strictures[J]. BJU Int, 2011, 107(1): 6-26. DOI: 10.1111/j.1464-410X.2010.09800.x.

ANDRICH D E, MUNDY A R. What is the best technique for urethroplasty?[J]. Eur Urol, 2008, 54(5): 1031-1041. DOI: 10.1016/j.eururo.2008.07.052.

BRYK D J, ZHAO L C. Guideline of guidelines: a review of urological trauma guidelines[J]. BJU Int, 2016, 117(2): 226-234. DOI: 10.1111/bju.13040.

BASCOM A, GHOSH S, FAIREY A S, et al . Assessment of wound complications after bulbar urethroplasty: the impact of a lambda perineal incision[J ] . Urology, 2016, 90: 184-188. DOI: 10.1016/j.urology.2015.12.047.

LIN Y F, LUO D Y, LIAO B H, et al . Perineal midline vertical incision verses inverted-U incision in the urethroplasty: which is better?[J ] . World J Urol, 2018, 36(8): 1267-1274. DOI: 10.1007/s00345-018-2267-x.

WESSELLS H, ANGERMEIER K W, ELLIOTT S, et al . Male urethral stricture: American Urological Association Guideline[J ] . J Urol, 2017, 197(1): 182-190. DOI: 10.1016/j.juro.2016.07.087.

MA Y C, JIAN Z Y, LI H, et al . Preoperative urine nitrite versus urine culture for predicting postoperative fever following flexible ureteroscopic lithotripsy: a propensity score matching analysis[J ] . World J Urol, 2021, 39(3): 897-905. DOI: 10.1007/s00345-020-03240-w.

MA L, LIU L, TIAN Y, et al . Bacteriostasis evaluation of the different soaking solutions in perineal skin preparation before the male urethral open operation: a randomized controlled trial[J ] . Int J Uro Nursing, 2015, 9(2): 74-77. DOI: 10.1111/ijun.12051.

BARBADORO P, MARMORALE C, RECANATINI C, et al . May the drain be a way in for microbes in surgical infections?[J ] . Am J Infect Control, 2016, 44(3): 283-288. DOI: 10.1016/j.ajic.2015.10.012.

LIGHTNER D J, WYMER K, SANCHEZ J, et al . Best practice statement on urologic procedures and antimicrobial prophylaxis[J ] . J Urol, 2020, 203(2): 351-356. DOI: 10.1097/JU.0000000000000509.

ANGER J T, SANTUCCI R, GROSSBERG A L, et al . The morbidity of urethral stricture disease among male medicare beneficiaries[J ] . BMC Urol, 2010, 10: 3. DOI: 10.1186/1471-2490-10-3.

WILLI S, PATRICK R, HARALD B. Selection of important variables and determination of functional form for continuous predictors in multivariable model building[J]. Stat Med, 2007, 26(30): 5512-5528.

PEDUZZI P, CONCATO J, KEMPER E, et al . A simulation study of the number of events per variable in logistic regression analysis[J ] . J Clin Epidemiol, 1996, 49(12): 1373-1379. DOI: 10.1016/S0895-4356(96)00236-3.

DAKUM N K, RAMYIL V M, AMU C O. Outcome of urethroplasty for urethral stricture at Jos Universitry Teaching Hospital[J]. Niger J Clin Pract, 2008, 11(4): 300-304.

MATHUR R K, SHARMA A K, GROVER J. Comprehensive analysis and urethroscopic evaluation of "U" shaped prostatobulbar anastomotic urethroplasty[J]. Asian J Surg, 2009, 32(3): 151-156. DOI:10.1016/s1015-9584(09)60386-9.

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