肾移植患者术后感染分析与防治对策

目的探讨肾移植患者术后感染的规律，以制定有效的预防控制措施。方法对某医院2007年6月-2010年6月接受肾移植手术的351例患者进行跟踪研究。结果调查期间，肾移植患者术后感染率为18.80%（66/351），其中住院期间医院感染率2.85%（10/351），出院后感染率15.95%（56/351）。出院后感染的患者中，73.21%（41/56）发生在出院后3个月以内。感染患者均以发热为首发症状。55例出院后发生呼吸道感染者病原体阳性率仅16.36%（9/55），其中3例痰培养检出凝固酶阴性葡萄球菌，1例检出肺炎克雷伯菌，1例检出铜绿假单胞菌，4例检出卡氏肺孢子菌。结论肾移植患者出院后3个月内感染危险性最大，是控制感染的重点时期。

Infection after kidney transplantation

Objective To evaluate the features of infection after kidney transplantation, so as make effective pre- vention and control measures. Methods Follow-up study was conducted on 351 patients who received kidney transplantation in a hospital from June 2007 to June 2010. Results Post-operative infection rate in kidney transplant patients was 18. 80% （66/351）, 2. 85% （10/351） of whom were infected during hospital stay, 15.95% （56/351） were infected after discharged from hospital. Among patients who were infected after discharged from hospital, 73.21% （41/56） developed infection within 3 months after discharged. The initial symptom of all patients was fever. Among 55 patients with respiratory tract infection after discharged from hospital, positive detection rate of pathogens was only 16. 36%（9/55）, sputum culture of 3 patients were detected coagulasemegative Staphylococcus, l patient was detected Klebsiella pneumoniae, 1 patient was detected Pseudomonas aeruginosa, and 4 were detected Pneumocystis carinii. Conclusion Patients are at the biggest risk of infection within 3 months after discharge, which is the key period for controlling infection.