Urinary Tract Infection Due To Indwelling Catheter After Radical Hysterectomy: A Clinical Analysis

Objective:To investigate the cause, management and prevention of urinary tract infection due to indwelling catheter after radical hysterectomy.Methods:This is a prospective study, a total of 81 patients with cervical cancer and endometrial cancer were admitted in in Shenzhen People's Hospital from Dec,2009 to Mar 2011. All of the cases were undergoing radical hysterectomy, and no urinary tract infection before surgery. All of the factors what are may related to radical hysterectomy was detected through One-factor ANOVA, and then through Binary Logistic. To investigate the strains of pathogenic organisms and the drug resistance to antibiotic of the 81 patients.Results:1.Seventeen patients(20.99%) suffered from urinary tract infection due to indwelling catheter after radical hysterectomy.2.There was obvious difference in preoperative chemo and/or radiotherapy, type of indwelling catheter duration of indwelling catheter, number of recatheterization, duration of antibiotics, post-operative morbidity and retention between the patients of urinary tract infection to non-infection(p<0.050).3.After Binary Logistic,we knew post-operative retention, type of indwelling catheter, duration of antibiotics and post-operative morbidity is related to urinary tract infection.4.The incidence of urinary tract infection after radical hysterectomy in different time is: 2.47%(3day),4.94%(7day),25.0%(14day).The incidence of urinary tract infection after radical hysterectomy in different time of duration of indwelling catheter is:4.88%(less than 14 days),20.69%(between 14 and 21 days),80.00%(between 21 and 28 days),83.33%(more than 28 days). The correlation analysis indicated that the incidence of urinary tract infection has a positive correlation with duration of indwelling catheter.5.The pathogens of patients with postoperative urethral catheterization were Escherichia coli, Enterococcus faecalis, Staphylococcus, Klebsiella pneumoniae and A.baumannii, no Candida tropicalis. The incidence of them is 42.11%,21.05%,15.78%,10.53% and 10.53%, respectively.6. Gram-negativeisolates were more sensitive to amikacin, piperacillin-tazobactam and imipenem, while gram-positive isolates were highly sensitive to vancomycin, teicoplanin and linezolid. And the susceptibilities were over 90.00% and 100.00% respectively. Conclusion:Urinary tract infection due to Indwelling Catheter is one of common complications after radical hysterectomy, and is a multi-factors with perioperation.Suprapubic catheterization is associated with a lower incidence of urinary tract infections than transurethral catheterization.There was positive correlation between the duration of indwelling catheter and the incidence of urinary tract infection in post-sugery.The most common urinary tract infection pathogens is Escherichia coli and Enterococcus faecalis.