Study on the relationship between urinary tract infection and ureteral stent after laparoscopic radical cystectomy
Objective:To preliminarily investigate the risk factors in urinary tract infection(UTI)following the removal of ureteral stent,and to summarize the spectrum of pathogens and their sensitive drugs.Methods:A pro-spective randomized grouping method was employed to conduct a case series study on 60 patients who underwent laparoscopic radical cystectomy in Peking Union Medical College Hospital from Aug.2019 to Oct.2022.Logistic regression analysis was used to identify the risk factors in UTI after stent removal.Differences in antimicrobial sensitivity test results were observed and described,and the patterns of postoperative infections were summarized.Results:In the experimental group,17 patients(56.67％)had positive cultures at the tip of the catheter,and 8 pa-tients(26.67％)eventually developed infections.In the control group,19 patients(63.33％)had positive cul-tures,and 14 patients(46.67％)developed infections.The application of carbapenem antibiotics within 6 hours af-ter stent removal significantly reduced the risk of post-removal UTI(P=0.038,OR=2.414).Increased body mass index,a history of diabetes,decreased preoperative albumin levels,and postoperative return to the ICU were identified as independent risk factors in UTI after stent removal.The most common pathogens causing UTI after stent removal were Escherichia coli and Enterococcus.Blood cultures conducted after stent removal to identify pathogens had a certain false-positive rate and delayed detection.Conclusion:The use of carbapenem antibiotics during stent removal effectively reduces the risk of post-removal UTI.For patients undergoing radical bladder re-section with diversion of intestinal urine flow,it is recommended to conduct catheter tip cultures and antimicrobial sensitivity tests simultaneously with stent removal to guide subsequent treatment.
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