Clinicopathologic and Etiologic Characteristics of Urinary Tract Infections in Patients with Cervical Cancer Undergoing Radical Operation with Indwelling Ureteral Stents.

Abstract

Background: The objective of this study was to investigate the clinicopathologic and etiologic characteristics of urinary tract infections in patients with cervical cancer who had undergone radical operation with ureteral stent insertion. Patients and Methods: We conducted a retrospective analysis on the medical records of 24 patients who underwent radical operation for cervical cancer with indwelling ureteral stents at Shanghai General Hospital between April 2019 and December 2022. Results: A total of 15 patients experienced urinary tract infections, resulting in an infection rate of 62.5%. Although postoperative adjuvant chemotherapy might have been a potential risk factor for urinary tract infections, the difference was not statistically significant (p = 0.074). A total of 30 pathogen strains were isolated, with Escherichia coli being the most prevalent. Notably, two strains of carbapenem-resistant Enterobacteriaceae were identified. The majority of patients (70.83%) had ureteral stents in place for 3-12 months. As the duration of stent insertion exceeded 2 months, we noted a decrease in antibiotic sensitivity against the same pathogen. Furthermore, fungal infections became more prevalent when the stent placement duration surpassed 4 months. Conclusions: The incidence of urinary tract infection is exceptionally high in patients with locally advanced cervical cancer and who have undergone radical operation with ureteral stent insertion. E. coli strains exhibited relative resistance to penicillins and cephalosporins. With prolonged stent placement, there was a notable diminution in antibiotic sensitivity against the same pathogen, and the microbial profile shifted from bacteria to fungi. This study provides valuable insights for the determination of the optimal timing for stent removal or replacement and for the selection of effective antibiotics to treat urinary tract infections for patients with indwelling ureteral stents, so as to ultimately prevent severe infections and mitigate disease burden.