肾移植术后医院感染的临床特点

目的探讨肾移植术后患者医院感染特点及其危险因素. 方法对92例同种异体肾移植住院患者回顾性调查,分感染组与非感染组,调查医院感染特点及对照分析临床危险因素. 结果 92例术后患者有44例70例次医院感染,感染率47.8%,例次感染率为76.1%;主要病原微生物G 菌占47.7%,有金黄色葡萄球菌和肠球菌属;其次G-菌占31.8%,有大肠埃希菌、克雷伯菌属、阴沟肠杆菌及假单胞菌属和真菌(20.5%), 并检出2例卡氏肺孢子虫;感染重点部位为肺、上呼吸道、泌尿道、口腔和伤口等;危险因素中术前血透时间、术程、留置尿管时间和长期住院、第三代头孢菌素应用与医院感染关系密切. 结论控制上述危险因素可以预防医院感染的发生.

Characteristics of Nosocomial Infection after Renal Transplantation

OBJECTIVE To elucidate the characteristics of nosocomial infection(NI) and its risk factors after renal transplantation(RT). METHODS It was accomplished to study retrospectively in 92 hospitalized patients with homograft kidney transplantation in a hospital from Sept 1999 to Sept 2001. All cases were allocated into two groups, the NI group and the non NI group, and the results were analyzed statistically. RESULTS In 92 cases of PostRT, 44 cases were acquired NI at 70 infection sites. The rate of infection was 47 8% and the incidence of infectious site was 76 1%. The most common pathogens were Gram positive cocci (47 7%), Staphylococcus aureus and enterococci; after that were Gram negative bacilli (31 8%), they were Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas; and 20 5% pathogens were fungi. Besides them,two isolates of microorganisms were verified as Pneumocystis carinii. Lung and the upper respiratory tract were the most frequent infection sites, followed by urinary tract, oral cavity and incision. NI was closely related to the factors such as hemodialysis duration preoperatively, operation hours, indwelling catheter procedures, long term hospitalization and clinical usage of the third generation cephalosporins. CONCLUSIONS It is feasible to prevent NI by controlling the above mentioned risk factors.