摘要
目的 分析肾移植患者术后感染情况、病原菌分布特点和耐药性.方法 回顾性分析2021年2月至2023年2月郑州市第七人民医院收治的172例肾移植患者的临床资料,根据术后是否发生感染分为感染组(54例)和非感染组(118例).记录患者感染时间和感染类型.通过全自动微生物分析仪分离鉴定病原菌,通过纸片扩散法进行药敏试验.结果 患者肾移植术后常见肺部感染(51.85％)和泌尿感染(31.48％),术后2～6个月为感染高峰.感染病原菌以革兰阴性菌为主(58.33％),主要为铜绿假单胞菌(19.44％)、肺炎克雷伯菌(16.67％)和表皮葡萄球菌(15.28％).主要致病革兰阴性菌对头孢唑林、左氧氟沙星、头孢吡肟、头孢噻肟、头孢他啶和氨苄西林的耐药率高,对亚胺培南和美罗培南的敏感度较高.主要致病革兰阳性菌对替考拉宁、万古霉素、复方新诺明和舒普深等抗菌药物较为敏感,而对红霉素、克林霉素等药物耐药性较高.结论 临床可根据医院肾移植术后感染病原菌分布和耐药性情况,综合考虑患者实际情况对症用药,以提高治疗效率,尤其在术后2～6个月的关键期.
Abstract
Objective To explore infection,distribution characteristics of pathogens and drug resistance in patients after kidney transplantation.Methods Retrospective analysis of clinical data of 172 kidney transplant patients admitted to Zhengzhou Seventh People's Hospital from February 2021 to February 2023,divided into infection group(54 cases)and non infection group(118 cases)based on whether postoperative infection occurred.The time and type of infection of the patient are recorded.Isolate and identify pathogens through a fully automated microbiological analyzer,and conduct drug sensitivity tests using paper diffusion method.Results After kidney transplantation,common pulmonary infections(51.85％)and urinary tract infections(31.48％)were observed in patients,with a peak of infection occurring 2-6 months after surgery.The main pathogens were Gram-negative bacteria(58.33％),mainly including Pseudomonas aeruginosa(19.44％),Klebsiella pneumoniae(16.67％)and Staphylococcus epidermoides(15.28％).The resistance rates of main Gram-negative bacteria were high to cefazolin,levofloxacin,cefepime,cefotaxime,ceftazidime and ampicillin,and their sensitivity was also high to imipenem and meropenem.The main Gram-positive bacteria were sensitive to teicoplanin,vancomycin,compound sulfamethoxazole and sulperazone,and their resistance was high to erythromycin and clindamycin.Conclusion Clinically,symptomatic medication can be administered based on the distribution and drug resistance of pathogenic bacteria after kidney transplantation in hospitals,taking into account the actual situation of patients,in order to improve treatment efficiency,especially during the critical period of 2-6 months after surgery.
维普
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