肾移植受者422例病原菌感染分析  

An analysis of pathogenic bacteria infection in 422 kidney transplant recipients

作　　者：郭娟[1] 郑珊[2] 谢辉[1] 胡亚会 Guo Juan;Zheng Shan;Xie Hui;Hu Yahui(Department of Laboratory Medicine,People’s Hospital of Zhengzhou,Zhengzhou 450003,Henan Province,China;Department of Kidney Transplantation,People’s Hospital of Zhengzhou,Zhengzhou 450003,Henan Province,China)

机构地区：[1]郑州人民医院检验科,河南省郑州市450003 [2]郑州人民医院肾移植科,河南省郑州市450003

出　　处：《中国组织工程研究》2020年第32期5198-5202,共5页Chinese Journal of Tissue Engineering Research

基　　金：河南省医学教育研究项目(Wjlk2018286),项目负责人:谢辉;河南省医学科技攻关计划联合共建项目(2018020824),项目负责人:胡亚会。

摘　　要：背景:了解肾移植受者细菌感染的类型和特点,分析肾移植术后医院感染病原菌分布及细菌耐药性变迁趋势,旨在为临床医生提供精准有效的治疗和防控措施,达到对肾移植受者临床合理使用抗菌药物的目的。目的:探讨肾移植受者术后医院感染流行病学特点。方法:对2014年8月至2019年8月在郑州人民医院肾移植中心术后发生病原菌感染的422例受者进行调查,包括标本类型、病原菌分布、病原菌耐药率等。该临床研究的实施符合郑州人民医院对研究的相关伦理要求。结果与结论:①肾移植受者发生病原菌感染阳性标本主要来自于痰液、尿液和外周血;②422株病原菌中革兰阴性菌274株(占64.9%),革兰阳性菌75株(占17.8%),真菌73株(占17.3%),其中革兰阴性菌分离率较高的分别为肺炎克雷伯菌、鲍曼不动杆菌和大肠埃希氏菌,革兰阳性菌分离率较高的是金黄色葡萄球菌、屎肠球菌和表皮葡萄球菌;③革兰阴性菌对多数抗菌药物的耐药率均较高,革兰阳性菌除了对万古霉素、替考拉宁和利奈唑胺完全敏感外,对其他抗菌药物有不同程度的耐药率;④结果表明,肾移植受者感染的致病菌以革兰阴性菌为主,其中大多数病原菌对多种抗生素耐药率偏高,有的已产生多重耐药性,应加强对肾移植受者耐药性的监管,合理使用抗菌药物。BACKGROUND:In this study,we investigated the types and characteristics of bacterial infections in kidney transplant recipients,and analyzed the distribution of pathogenic bacteria for nosocomial infections and the changes in bacterial resistance after kidney transplantation,with the attempt to provide accurate and effective measures for prevention and treatment of bacterial infection and achieve the rational clinical use of antimicrobial drugs for kidney transplant recipients.OBJECTIVE:To investigate the epidemiological characteristics of nosocomial infection in renal transplantrecipients.METHODS:A total of 422 patients with pathogenic bacteria infection after kidney transplantation in the Center of Kidney Transplantation,Zhengzhou People’s Hospital were investigated from August 2014 to August 2019,including specimen types,distribution of pathogenic bacteria and drug resistance of pathogens.The implementation of this study complied with the relevant ethical requirements of Zhengzhou People’s Hospital.RESULTS AND CONCLUSION:Positive specimens of pathogenic bacteria infection after kidney transplantation were from sputum,urine and peripheral blood mainly.Of the 422 strains of pathogenic bacteria,274 strains(64.9%)were gram-negative,75 strains(17.8%)were gram-positive and 73 strains(17.3%)were fungi.Among them,gram-negative bacteria were isolated from Klebsiella pneumoniae,Acinetobacter and Escherichia coli.Staphylococcus aureus,Enterococcus faecium and Staphylococcus epidermidis had higher isolation rate of gram-positive bacteria.The resistance rate of gram-negative bacteria to most antimicrobial agents was high.The gram-positive bacteria tested had different degrees of resistance to the other antimicrobial agents besides being completely sensitive to vancomycin,teicoplanin and linezolid.To conclude,gram-negative bacteria are the main pathogenic bacteria in kidney transplantation recipients.Most of the pathogenic bacteria are highly resistant to many antibiotics,and some of them have developed multiple resistan

关 键 词：肾 肾移植 移植 抗生素 耐药 耐药性 病原菌 感染 

分 类 号：R446[医药卫生—诊断学] R37[医药卫生—临床医学]