Analysis of pathogen distribution, drug sensitivity and inflammatory indicators related to pelvic infection after...

To analyse the distribution of pathogens, risk factors and inflammatory indicators related to pelvic infection after hysterectomy.

Patients who underwent hysterectomy at Women's Hospital of Nanjing Medical University between January 2022 and January 2023 were recruited into this study. Vaginal secretions from patients with suspected postoperative pelvic infection were collected for pathogen cultivation, identification, and antimicrobial susceptibility analysis. Receiver operating characteristic curves were plotted to analyse the efficacy of various inflammatory indicators in diagnosing pelvic infection.

There were 58 cases of pelvic infection in 2045 patients after hysterectomy. In total, 1068 strains of pathogenic bacteria were isolated from the vaginal secretions of 1734 patients, including 662 strains of Gram-negative bacteria. Escherichia coli was the main pathogen, with > 90% susceptibility to amikacin, imipenem, meropenem and piperacillin. Mean ± standard deviation white blood cell count, C-reactive protein (CRP), neutrophil ratio, neutrophil:lymphocyte ratio, platelet:lymphocyte ratio, and systemic immune inflammation index (SII) were 13.77 ± 3.25 10⁹ /L, 69.21 ± 14.36 mg/L, 89.20 ± 2.17%, 12.85 ± 3.55%, 235.94 ± 46.27% and 2002.16 ± 340.06, respectively, in the postoperative infection group. Corresponding values for the control group were 7.66 ± 1.58 10⁹ /L, 17.87 ± 5.74 mg/L, 84.73 ± 6.30%, 9.04 ± 1.09%, 198.84 ± 38.33% and 1840.86 ± 215.34; the differences were significant (p < 0.05). Area under the curve values for the diagnosis of pelvic infection were 0.911, 0.825, 0.873, 0.896, 0.835 and 0.904, respectively.

Amikacin and piperacillin may be preferred for Gram-negative bacterial pelvic infections after hysterectomy. CRP, white blood cell count, neutrophil:lymphocyte ratio, neutrophil ratio, platelet:lymphocyte ratio and SII can all be used as predictors of pelvic infection, but CRP and SII had the highest sensitivity and specificity.