肾移植术后感染患者病原菌分布特点及危险因素分析  

Distribution characteristics of pathogens and risk factors for infection after kidney transplantation

作　　者：尚鑫[1] 张莉[1] SHANG Xin;ZHANG Li(Department of Laboratory Medicine,the 7 th People's Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第七人民医院检验科,河南郑州450000

出　　处：《新乡医学院学报》2024年第12期1140-1143,1148,共5页Journal of Xinxiang Medical University

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20210743)。

摘　　要：目的探讨肾移植术后感染患者病原菌分布特点,并分析其危险因素。方法选择2020年1月至2023年12月在郑州市第七人民医院接受肾移植的495例患者为研究对象,根据术后1个月内是否发生感染将患者分为非感染组和感染组。统计肾移植术后感染发生率、感染部位及病原菌分布情况,并采用单因素和二元logistic回归分析肾移植术后感染的危险因素。结果495例肾移植患者术后1个月内感染发生率为16.16%(80/495),其中泌尿系统感染是最常见的感染部位,发生率为71.43%(65/91)。活体肾移植和尸体肾移植术后感染发生率比较差异无统计学意义(P>0.05)。80例肾移植术后感染患者感染部位分泌物中共检出病原菌109株,其中革兰阴性菌63株(57.80%),革兰阳性菌43株(39.45%),真菌3株(2.75%)。单因素分析结果显示,术前白蛋白(ALB)、血红蛋白(Hb)水平及术前是否透析、住院时间和尿管留置时间与术后感染有关(P<0.05);性别、年龄、高血压、高脂血症、糖尿病、冠状动脉性心脏病、透析时间以及术前白细胞计数、中性粒细胞计数、血肌酐水平和供体情况、移植后排斥反应与术后感染无关(P>0.05)。二元logistic回归分析结果显示,术前低ALB和Hb水平、术前透析、住院时间>30 d及尿管留置时间>3 d是导致肾移植术后感染发生的危险因素(P<0.05)。结论肾移植术后细菌感染风险较高,泌尿系统是其常见感染部位之一,术前低ALB和Hb水平、术前透析、住院时间>30 d及尿管留置时间>3 d是肾移植术后感染发生的危险因素。Objective To investigate the distribution characteristics of pathogens in patients with infection after kidney transplantation,and analyze their risk factors.Methods A total of 495 patients who underwent kidney transplantation at the 7 th People's Hospital of Zhengzhou from January 2020 to December 2023 were selected as the research subjects,and they were divided into non-infection group and infection group based on whether they were infected within one month after surgery.The infection incidence rate,infection site and distribution of pathogens after kidney transplantation were statistically analyzed,and the risk factors for infection after kidney transplantation were analyzed by using univariate and binary logistic regression.Results The infection incidence rate within one month after kidney transplantation in 495 patients was 16.16%(80/495),of which,the infection mostly occurred in the urinary system,with an incidence rate of 71.43%(65/91).There was no statistically significant difference in the infection incidence rate between living kidney transplantation and cadaveric kidney transplantation(P>0.05).A total of 109 pathogens were detected in the secretions from the infection sites of 80 patients with infection after kidney transplantation,including 63(57.80%)Gram negative bacteria,43(39.45%)Gram positive bacteria,and 3(2.75%)fungi.The results of univariate analysis showed that preoperative albumin(ALB)and hemoglobin(Hb)levels,preoperative dialysis status,length of hospital stay,and indwelling catheterization time were correlated with postoperative infection(P<0.05);while the sex,age,hypertension,hyperlipidemia,diabetes,coronary heart disease,dialysis time,preoperative white blood cell count,neutrophil count and serum creatinine level,donor status,and rejection after transplantation were not associated with postoperative infection(P>0.05).The results of binary logistic regression analysis showed that preoperative low levels of ALB and Hb,preoperative dialysis,length of hospital stay>30 days,and indwelling cath

关 键 词：肾移植 感染 病原菌分布 危险因素 

分 类 号：R446.5[医药卫生—诊断学] R699.2[医药卫生—临床医学]