供肝灌注液病原菌与肝移植术后早期感染的相关性分析  

Correlation analysis between pathogenic bacteria of donor liver perfusion fluid and early infection after liver transplantation

作　　者：李秉林 吕少诚[1] 潘飞[1] 姜涛[1] 樊华[1] 寇建涛[1] 贺强[1] 郎韧[1] Li Binglin;Lyu Shaocheng;Pan Fei;Jiang Tao;Fan Hua;Kou Jiantao;He Qiang;Lang Ren(Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院肝胆外科,100020

出　　处：《中华肝脏外科手术学电子杂志》2023年第6期656-660,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

摘　　要：目的探讨供肝灌注液病原菌与受者肝移植术后早期感染的相关性。方法回顾性分析2019年12月至2022年6月首都医科大学附属北京朝阳医院行同种异体原位肝移植术的138例受者临床资料。受者或(和)家属均签署知情同意书,符合医学伦理学规定。其中男116例,女22例;年龄27~65岁,中位年龄50岁。分析供肝灌注液培养结果与受者肝移植术后早期感染情况。结果138例肝移植受者中,供肝灌注液病原学培养阳性率51.4%(71/138),共分离菌株104株,常见病原菌为凝固酶阴性葡萄球菌(45株)、屎肠球菌(9株)和大肠埃希菌(7株)。受者肝移植术后感染发生率28.3%(39/138),共培养分离出81株病原菌,常见病原菌为肺炎克雷伯菌(13株)、凝固酶阴性葡萄球菌(13株)和大肠埃希菌(7株)。供肝灌注液培养阳性组受者术后感染发生率为39.4%(28/71),明显高于阴性组的16.4%(11/67)(χ^(2)=9.009,P<0.05)。28例阳性组术后发生感染的受者中,9例受者供肝灌注液与术后感染培养出相同病原菌;其中最多的是肺炎克雷伯菌,供肝灌注液培养阳性6例,术后感染培养阳性5例,一致率5/6。结论肝移植术后早期感染发生率高,供肝灌注液病原学培养结果阳性受者术后感染发生率高于阴性受者,其中肺炎克雷伯菌具有病原菌高度一致性。Objective To investigate the correlation between pathogenic bacteria of donor liver perfusion fluid and early infection of recipients after liver transplantation.Methods Clinical data of 138 recipients who underwent orthotopic liver transplantation in Beijing Chaoyang Hospital,Capital Medical University from December 2019 to June 2022 were retrospectively analyzed.The informed consents of all patients or(and)their family members were obtained and the local ethical committee approval was received.Among them,116 patients were male and 22 female,aged from 27 to 65 years,with a median age of 50 years.The results of donor liver perfusion culture and early infection of recipients after liver transplantation were analyzed.Results Among 138 recipients of liver transplantation,the positive rate of pathogenic culture of donor liver perfusion was 51.4%(71/138),and 104 strains were isolated.The common pathogens included 45 strains of coagulase-negative Staphylococci,9 strains of Enterococcus faecium and 7 strains of Escherichia coli.The incidence of recipient infection after liver transplantation was 28.3%(39/138),and 81 strains of pathogenic bacteria were isolated.The common pathogens included 13 strains of Klebsiella pneumoniae,13 strains of coagulase-negative Staphylococcus and 7 strains of Escherichia coli.The incidence of postoperative infection was 39.4%(28/71)in the positive donor liver perfusion group,significantly higher than 16.4%(11/67)in the negative group(χ^(2)=9.009,P<0.05).Among 28 recipients with postoperative infection in the positive group,identical pathogens were isolated in donor liver perfusion and postoperative infection culture of 9 recipients.Klebsiella pneumoniae was the most common pathogen,which was detected in donor liver perfusion culture of 6 cases and in postoperative infection culture of 5 cases,with a consistency rate of 5/6.Conclusions The incidence of early infection after liver transplantation is high.The incidence of postoperative infection in recipients with positive results in donor li

关 键 词：肝移植 灌注液 病原菌培养 术后感染 

分 类 号：R657.3[医药卫生—外科学]