OBJECTIVE To explore the risk factors and etiological characteristics of postoperative nosocomial infections in the patients undergoing ureteral flexible holmium laser lithotripsy.

METHODS The clinical data were collected from 479 patients who underwent ureteral flexible holmium laser lithotripsy in 928 Hospital of People′s Liberation Army Joint Service Support Force from Feb 2021 to Dec 2022 and were retrospectively analyzed, the enrolled patients were divided into the infection group with 51 cases and the non-infection group with 428 cases according to the status of postoperative nosocomial infection. The etiological characteristics of the infections and the infection sites were statistically analyzed. Multivariate logistic analysis was performed for the risk factors for the postoperative nosocomial infections.

RESULTS Among the 479 patients who underwent the ureteral flexible holmium lithotripsy, 51 had postoperative nosocomial infections, with the incidence rate 10.65%. Totally 59 strains of pathogens were isolated from the 51 patients with infections, 37 (62.71%) of which were gram-negative bacteria, 17 (28.81%) were gram-positive bacteria, and 5 (8.47%) were fungi. The patients who had urinary system infections were dominant among the patients with the infections, accounting for 56.86%. The result of multivariate logistic analysis showed that preoperative complication with urinary tract infection, complication with diabetes mellitus, operation duration more than 60 min, no prophylactic use of antibiotics and urinary catheter indwelling time more than 7 days were the risk factors for the postoperative nosocomial infections in the patients undergoing ureteral flexible holmium laser lithotripsy(OR=2.737, 3.111, 2.540, 2.754, 2.735, P < 0.05).

CONCLUSION The incidence of postoperative nosocomial infections is high among the patients undergoing ureteral flexible holmium laser lithotripsy, the urinary system is the major infection site. The gram-negative bacteria are dominant among the pathogens. The incidence of postoperative nosocomial infections is associated with the preoperative complication with urinary tract infection, history of diabetes mellitus, operation duration, prophylactic use of antibiotics and urinary catheter indwelling time. It is necessary for the hospital to take targeted intervention measures in early stage.