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肝移植术后细菌性感染的病原学特征
引用本文:周建党,朱晒红,陈颖,聂新民,彭怀燕,成柯.肝移植术后细菌性感染的病原学特征[J].中南大学学报(医学版),2005,30(4):430-432.
作者姓名:周建党  朱晒红  陈颖  聂新民  彭怀燕  成柯
作者单位:中南大学湘雅三医院1.检验科;2.移植研究院,长沙 410013
基金项目:湖南省卫生厅科研项目(B2004-067)
摘    要:目的:分析肝移植术后感染的主要病原菌及病原菌的耐药特征。方法:分析肝移植术后感染的主要病原菌,运用三维试验检测主要革兰阴性杆菌的超广谱β-内酰胺酶(extended-spectrum β-lactamase,ESBLs)、AmpC酶等产生情况与变化,以头孢硝基噻吩显色法、琼脂稀释法检测肠球菌的β-内酰胺酶和Van基因。结果:肝移植术后感染主要病原菌为粪肠球菌(15.0%)、阴沟肠杆菌(13.9%)、真菌(13.3%)、大肠杆菌(10.7%)。阴沟肠杆菌和大肠杆菌的ESBLs酶检出率分别为32.4%和36.8%;AmpC酶的检出率为33.8%和10.5%,粪肠球菌和屎肠球菌的Van基因检出率分别是VanA 7.5%和11.1%,VanB 3.8%和7.4%,VanC 1.3%和0。结论:肝移植术后以肠源性感染为主,产ESBLs与AmpC酶是肝移植术后革兰阴性杆菌耐药的主要机制,耐万古霉素的肠球菌在肝移植术后的检出率增高应引起临床重视。

关 键 词:肝移植  细菌感染  耐药基因  微生物学  
文章编号:1672-7347(2005)04-0430-03
收稿时间:2005-01-28
修稿时间:2005年1月28日

Pathogenic characters of infected bacteria after liver transplantation
ZHOU Jian-dang,ZHU Shai-hong,CHEN Ying,NIE Xin-min,PENG Huai-yan,Cheng Ke.Pathogenic characters of infected bacteria after liver transplantation[J].Journal of Central South University (Medical Sciences)Journal of Central South University (Medical Sciences),2005,30(4):430-432.
Authors:ZHOU Jian-dang  ZHU Shai-hong  CHEN Ying  NIE Xin-min  PENG Huai-yan  Cheng Ke
Institution:1.Department of Clinical Laboratory, Third Xiangya Hospital,Central South University,Changsha 410013,China;
2.Xiangya Transplation Medical Institute, Central South University,Changsha 410013,China
Abstract:OBJECTIVE: To analyze the main pathogens of infection after the liver transplantation and their antibiotic resistant patterns. METHODS: The main pathogens of infection after the liver transplantation were retrospectively analyzed. Using 3-dimensional tests, ESBLs (extended-spectrum beta-lactamase), and AmpC were detected among the Gram negative bacilli. beta-Lactamase and Van gene in Enterococcus were determined by the standard agar dilution susceptibility tests and Nitrocefin respectively. RESULTS: The main infected strains were Enterococcus faecalis (15.0%), Enterobacter cloacae (13.9%), fungus (13.3%), and Escherichia coli (10.7%) after the liver transplantation. Among them, 32.4% of Enterobacter cloacae and 36.8% of Escherichia coli produced ESBLs; 33.8% of Enterobacter cloacae and 10.5% of Escherichia coli. produced AmpC beta-lactamases. The detectable rate of VanA gene in Enterococcusfaecalis and Enterococcus faecium was 7.5% and 11.1%; VanB was 3.8% and 7.4%; VanC was 1.3% and 0, respectively. CONCLUSION: The infection mainly occurs in the intestinal tract after the liver transplantation. The production of ESBLs and AmpC beta-lactamases is the main mechanism of antibiotic resistance. The increased detectable rate of vancomycin-resistant Enterococcus should be paid attention to.
Keywords:liver transplantation  bacterial infection  resistance gene  microbiology
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