肝移植术后耐甲氧西林金黄色葡萄球菌血流感染危险因素的17年回顾性分析

目的探讨本院肝移植术后耐甲氧西林金黄色葡萄球菌（MRSA）血流感染的危险因素及临床结果。方法回顾分析1993年1月至2010年5月肝移植术后血液MRSA阳性感染者的资料。结果 695例肝移植患者中,53例（7.6%）出现革兰氏阳性球菌血流感染,以肠球菌最为常见,7例病人发生7次MRSA血流感染。分析肝移植术后MRSA血流感染的危险因素发现,急性排斥（P=0.03）是出现MRSA血流感染的危险因素。肝移植术后MRSA血流感染与非MRSA血流感染的15d、30d、1年病死率差异无统计学意义。结论急性排斥是出现肝移植术后MRSA血流感染的危险因素,但肝移植术后MRSA血流感染后15d、30d、1年的死亡率未明显增加。

A 17-year retrospective study of the risk factor of bloodstream infection with MRSA after liver transplantation

Objective To define the risk factor and mortality of methicillin-resistant Staphylococcus aureus（MRSA） of bloodstream infections（BSI） after liver transplantation. Method From January 1993 to May 2010, a retrospective analysis of methicillin-resistant Staphylococcus aureus in liver transplants are conducted. Results 53 out of 695 patients had BSI,commonly infected with enterococcus. Postoperative acquisition of MRSA was detected in 7 patients. Univariate analysis identified acute rejection was the risk factor for methicillin-resistant Staphylococcus aureus bacteremia（P=0.03）. No significant differences was found in mortality at 15 days,30 days and 1 year in methicillin-resistant Staphylococcus aureus bacteremia after liver transplantation. Conclusions Risk factor associated with methicillin-resistant Staphylococcus aureus of bloodstream infections was acute rejection. Methicillin-resistant Staphylococcus aureus bloodstream infection show no significance in mortality at 15 days, 30 days and 1 year after operation.