Clinicopathological and etiological characteristics for urinary tract infection in cervical cancer patients with radical surgery with double J stents

Abstract

Background To investigate the clinicopathological and etiological characteristics for urinary tract infection in cervical cancer radical surgery with indwelling ureteral stents. Methods A total of 24 patients who received cervical cancer radical surgery and retained with double J stent in Shanghai General Hospital from July 2018 to December 2022 were recruited as the study objects, the medical data were retrospectively analyzed, and the clinicopathological and etiological characteristics of the urinary tract infection were collected. Results Of the 24 cervical cancer patients with radical surgery patients with double J stent included in this study, 87.5% patients were locally advanced cervical cancer (LACC) and 73.91% patients received postoperative chemoradiotherapy. 58.33% patients had maximum diameter of cancer > 4cm and HPV 16 was present in 65% patients. Total 15 patients were complicated with urinary tract infection, with the infection rate reaching up to 62.5%. Postoperative adjuvant chemotherapy might be the risk factor for urinary tract infections, although no significant statistic difference was identified (P = 0.074). A total of 30 strains of pathogens were isolated from the patients with urinary tract infections. 10.00% were Gram-positive bacteria, 73.33% were Gram-negative bacteria, 16.67% were fungi. Escherichia coli were the most common pathogens of urinary tract infections. The Escherichia coli are resistant to ampicillin, ceftriaxone, cefotaxime, cefazolin and cefuroxime and sensitive to imipenem, meropenem, piperacillin/tazobactam, tigecycline and amikacin. Two strains of CRE (carbapenem resistant Enterobacteriaceae bacteria) were identified. 70.83% patients were inserted ureteral stents for 3 to 12 months. With the prolongation of ureteral stents placement, drug sensitivity for antibiotics targeting the same pathogen decreased and the pathogenic microbes changed from bacteria into fungi. Conclusions Ureteral tract infections were extremely high in LACC with radical surgery with ureteral stents insertion, with the rate reaching to 67.5%. Postoperative adjuvant chemotherapy might be the risk factor for urinary tract infections. The most common pathogens of urinary tract infections were Gram-positive bacteria, led by Escherichia coli. The Escherichia coli are relatively resistant to Penicillins and Cephalosporins and generally sensitive to Carbapenems and Glycylcyclines. This study could provide basis for clinicians to choose appropriate antibiotics for urinary tract infections during ureteral stents indwelling, preventing severe infections, reducing the burden of disease.