Aetiology and Prognostic Significance of Postoperative Urinary Tract Infections in Patients with Cervical Cancer.

Abstract

Background: This study aimed to investigate the risk factors for urinary tract infections (UTIs) in patients with cervical cancer (CC) following radical surgery, and analyse the etiological distribution and prognostic implications of these infections.

Methods: A retrospective analysis was conducted on the clinical data of 168 patients with CC who underwent radical surgery at our hospital between January 2021 and December 2023. Postoperative UTI incidence and associated risk factors were analysed. Postoperative urine samples were collected under sterile conditions for pathogen culture to analyse pathogen distribution. Patients were classified into poor and good prognosis groups based on their health status within one month of treatment. The relationship between pathogen distribution and prognosis in patients with CC and postoperative UTIs was analysed.

Results: The incidence of postoperative UTIs was 35.12% (59 cases). Among these patients, 84 pathogen strains were detected in urine samples, including 54 of gram-negative bacteria, 26 of gram-positive bacteria, and four of fungi. The single-factor analysis identified age, diabetic status, menopausal status, tumour diameter, surgical duration, intraoperative blood loss volume, duration of ureteral catheterisation, and postoperative urinary retention as potential risk factors. The multifactorial analysis confirmed age, diabetic status, operation duration, intraoperative blood loss volume, duration of ureteral catheterisation, and postoperative urinary retention as independent risk factors. The distribution of Klebsiella pneumoniae (K. pneumoniae) significantly differed between the study groups, while other pathogens showed no significant difference.

Conclusions: UTIs in patients with CC post-radical surgery are primarily caused by gram-negative bacteria, mainly Escherichia coli and K. pneumoniae. K. pneumoniae is predominant in patients with a poor prognosis, while Enterococcus spp. is the most common gram-positive bacterium observed.