Retrospective Study of the Etiology and Risk Factors of Systemic Inflammatory Response Syndrome After Systematic Transrectal Ultrasound-Guided Prostate Biopsy.
Retrospective Study of the Etiology and Risk Factors of Systemic Inflammatory Response Syndrome After Systematic Transrectal Ultrasound-Guided Prostate Biopsy.
复制标题
系统经直肠超声引导前列腺活检后全身炎症反应综合征的病因和危险因素的回顾性研究。
DOI：
10.2147/idr.s256548
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发表时间：
2020
影响因子：
3.9
通讯作者：
Jiang Z
中科院分区：
文献类型：
--
作者：
Lei H;Dong X;Li L;Huan F;Zhong X;Wu Q;Fang H;Zhang T;Yang X;Zhu J;Li J;Jiang Z
为探讨系统性经直肠超声引导下前列腺穿刺活检（TRUS-Bx）的危险因素、病原菌分布及耐药性，回顾性收集了2017年4月至2019年10月在陆军军医大学第二附属医院行TRUS-Bx的329例患者。329例患者全部合格，分为SIRS组（25例）和非SIRS组（304例）。分析全身炎症反应综合征（SIRS）的发生率及危险因素。同时采集TRUS-Bx术后SIRS患者的尿液和血液标本进行细菌培养和药敏试验。多因素Logistic回归分析显示，BMI ≥ 25 kg/m2（OR = 1.66，95%CI = 1.34-2.12，P <0.001），糖尿病史（OR = 5.48，95%CI = 1.53-19.68，P = 0.008），术前泌尿系感染血沉≥ 20 mm/h（OR = 1.04，95% CI = 1.01-1.08，P = 0.039）是TURS-PB术后SIRS的独立危险因素。全身炎症反应综合征和尿脓毒症的发生率分别为7.59%和2.13%，主要病原菌为大肠埃希菌（58.33%）、肺炎克雷伯菌（12.5%）和铜绿假单胞菌（12.5%）。亚胺培南、美罗培南、替加环素、哌拉西林/他唑巴坦、替考拉宁、万古霉素、阿米卡星、头孢哌酮/舒巴坦对上述病原菌有很强的抑制作用（敏感性85.72%~100%）。左氧氟沙星、环丙沙星、庆大霉素、青霉素G、复方新诺明、第二代头孢菌素对致病菌的抑制率较低，但也有较好的抑制率（42.86%~80.95%）。
To explore the risk factors, pathogenic bacteria distribution and drug resistance of systematic transrectal ultrasound-guided prostate biopsy (TRUS-Bx), 329 cases of TRUS-Bx were collected, retrospectively, in the Second Affiliated Hospital, Army Military Medical University, from April 2017 to October 2019. A total of 329 cases were all qualified and grouped into the SIRS group (25 cases) and the non-SIRS group (304 cases). Of all the cases, incidence and risk factors of systemic inflammatory response syndrome (SIRS) were analyzed. Urine and blood samples of patients with SIRS after TRUS-Bx were also collected for bacterial culture and drug sensitivity test. Multivariate logistic regression analysis showed that BMI ≥ 25 kg/m2 (OR = 1.66, 95% CI = 1.34–2.12, P <0.001), history of diabetes (OR = 5.48, 95% CI = 1.53–19.68, P = 0.008), urinary infection before operation (OR = 9.19, 95% CI = 2.92–20.93, P < 0.001) and erythrocyte sedimentation (ESR) ≥ 20 mm/h (OR = 1.04, 95% CI = 1.01–1.08, P = 0.039) were independent risk factors of SIRS after TURS-PB. The incidence of SIRS and urinary sepsis was 7.59% and 2.13%, respectively, and major pathogens of SIRS after TRUS-Bx were Escherichia coli (58.33%), Klebsiella pneumoniae (12.5%) and Pseudomonas aeruginosa (12.5%). Imipenem, meropenem, tigecycline, piperacillin/tazobactam, teicoplanin, vancomycin, amikacin and cefoperazone/sulbactam had a very strong inhibitory effect to those pathogenic bacteria (sensitivity 85.72%~100%). Levofloxacin, ciprofloxacin, gentamicin, penicillin G, compound neonomine and second-generation cephalosporins showed less but also worked as a good inhibitor to pathogenic bacteria (42.86%~80.95%).