Epidemiology of nosocomial infection in recipients after renal transplantation: a single-center analysis
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摘要:
目的 探讨肾移植受者术后医院感染流行病学特点及其防控措施。 方法 2014年1月至2017年12月对456例肾移植受者进行监测,分析肾移植术后医院感染情况,包括基本情况、感染部位、感染病原体类型。 结果 456例肾移植受者中,发生医院感染78例(17.1%),术后感染时间为9(3~21)d。感染部位主要为下呼吸道、泌尿系统和血流感染。感染病原体类型包括葡萄球菌13株、屎肠球菌6株、真菌6株、嗜麦芽窄食单胞菌4株、鲍曼不动杆菌4株、铜绿假单胞菌4株、表皮葡萄球菌4株、肺炎克雷伯菌1株、大肠埃希菌1株、其他阴性菌9株。其中多重耐药菌感染11例(14%),死亡4例。 结论 肾移植受者术后医院感染发生率较高、术后发病早、多重耐药菌感染常见且病死率高,应充分做好术前准备、积极预防术后下呼吸道感染、规范实施多重耐药菌防治措施。 Abstract:Objective To investigate the epidemiological characteristics of renal transplantation recipients, effective prevention and control measures. Methods A total of 456 renal transplant recipients were monitored from January 2014 to December 2017. Postoperative infection including baseline data, infection site and infectious pathogen type was analyzed. Results Among 456 renal transplant recipients, 78 cases (17.1%) developed nosocomial infection. Postoperative infection time was 9(3-21) d. Infection sites mainly included the lower respiratory tract, urinary system and blood infection. Infection pathogens consisted of Staphylococci (n=13), Enterococcus faecium (n=6), fungi (n=6), Stenotrophomonas maltophilia (n=4), Acinetobacter baumannii (n=4), Pseudomonas aeruginosa (n=4), Staphylococcus epidermidis (n=4), Klebsiella pneumoniae (n=1), Escherichia coli (n=1) and other negative bacteria (n=9). Among them, 11 cases (14%) were infected with multi-drug resistant bacteria, and 4 cases died. Conclusions In renal transplant recipients, the incidence of nosocomial infection is relatively high, with early postoperative onset, common multiple drug-resistant bacterial infection and high mortality. Preoperative preparations should be fully implemented, postoperative lower respiratory tract infection should be actively prevented and prevention and treatment measures for multidrug-resistant bacteria should be standardized. -
Key words:
- Renal transplantation /
- Fungus /
- Bacterium /
- Nosocomial infection /
- Pathogen /
- Epidemiological study
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表 1 78例肾移植受者术后感染部位的构成比
Table 1. Composition ratio of postoperative infection positions in 78 renal transplant recipients
感染部位 2014年 2015年 2016年 2017年 合计 感染例次 构成比(%) 感染例次 构成比(%) 感染例次 构成比(%) 感染例次 构成比(%) 感染例次 构成比(%) 下呼吸道 12 57 13 57 12 55 5 19 42 45 泌尿系统 4 19 5 22 6 27 10 37 25 27 血流 5 24 2 9 3 14 5 19 15 16 腹腔 0 0 0 0 0 0 1 4 1 1 术后伤口 0 0 1 4 0 0 1 4 2 2 其他 0 0 2 9 1 5 4 15 7 8 合计 21 100 23 100 22 100 26 100 92 100 表 2 78例肾移植受者术后感染病原体的构成比
Table 2. Composition ratio of postoperative infection pathogens in 78 renal transplant recipients
感染病原体 2014年 2015年 2016年 2017年 合计 菌株数 构成比(%) 菌株数 构成比(%) 菌株数 构成比(%) 菌株数 构成比(%) 菌株数 构成比(%) 鲍曼不动杆菌 1 5 1 9 1 14 1 8 4 8 铜绿假单胞菌 0 0 1 9 3 43 0 0 4 8 肺炎克雷伯菌 1 5 0 0 0 0 0 0 1 2 屎肠球菌 2 11 1 9 0 0 3 23 6 12 嗜麦芽窄食单胞菌 1 5 0 0 1 14 2 15 4 8 大肠埃希菌 1 5 0 0 0 0 0 0 1 2 表皮葡萄球菌 3 16 0 0 0 0 1 8 4 8 葡萄球菌 6 32 4 36 1 14 0 0 11 22 真菌 0 0 3 27 1 14 2 15 6 12 其他阴性菌 4 21 1 9 0 0 4 31 9 18 合计 19 100 11 100 7 100 13 100 50 100 -
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