肝移植术后细菌性感染的病原学特征及分布特点  

The distribution and pathogen of bacteria infection in patients after liver transplantation

作　　者：蔡常洁[1] 陆敏强[1] 李敏如[1] 杨扬[1] 易慧敏[1] 许赤[1] 李华[1] 易述红[1] 汪根树[1] 陈规划[1] 

机构地区：[1]中山大学附属第三医院肝移植中心,中山大学器官移植研究所,广州510630

出　　处：《中华外科杂志》2006年第15期1026-1028,共3页Chinese Journal of Surgery

基　　金：国家科技部973计划项目(2003CB515500);广东省自然科学基金资助项目(4105344);广州市科技计划项目(2005Z3-E0101)

摘　　要：目的研究肝移植术后细菌感染的流行病学规律。方法回顾性分析451例患者原位肝移植术后细菌学资料。结果肝移植术后239例患者出现细菌感染,细菌感染率为53．0％,共分离出菌株304株,其中革兰阳性(G+)球菌占59．9%(182／304),革兰阴性(G-)杆菌占40．1％(122／304)。易感器官依次为呼吸道和胆道,感染发生率分别为81．5％(248／304),15．1％(46／304)。呼吸道感染以G+菌为主,占65．3％,胆道感染以G-为主,占60．9％,两者有显著性差异(P<0．01)。结论肝移植术后细菌感染率高,主要以G+球菌感染为主,条件致病菌及多重耐药菌株较多见。肝移植术后细菌感染的菌群与部位间有明显相关关系,在预防或治疗感染时应针对不同感染部位采取不同措施。Objective To find out the epidemiology of bacteria infection after orthotopic liver transplantation （OLT）. Method Postoperative bacteria infection of 451 OLT cases were retrospectively analyzed. Result Bacteria infection were detected in 239 OLT cases, and the infection rate was 52.9%. Sum up to 304 bacilli lines were separated from all avobe cases. Among them, the detectable Gram-positive bacilli （G^＋ ） accounted for 59.9% （182/304）, while Gram-negative bacilli （G^-） accounted for 40. 2% （122/304）. The impressionable organ were respiratory tract and bile duct, which occupying 81.5% （248/ 304） and 15. 1% （46/304） among all infective cases respectively. The main infected strain were G^＋ bacteria in respiratory tract, account for 65.3% ; while G^- bacteria were mainly in bile duct, account for 60. 9%. There was significant difference between each other （P = 0. 018）. Conclusions The bacteria infection rate was high after OLT, and the main infected strain was the G ^＋ bacteria. Most fo them were the opportunistic pathogenic bacteria and the antibiotic multi-resistant bacteria. The bacteria category was significantly related to the infected tissue, according to which we could adopt corresponding antibacterial approach.

关 键 词：肝移植 感染 流行病学 

分 类 号：R657.3[医药卫生—外科学]