肾移植患者细菌谱的调查及耐药性的研究

目的：通过调查研究肾移植患者常见致病菌株分布特点及其对抗生素敏感性的规律，进一步提高临床治疗肾移植后感染患者的成功率。方法：1997年4月－2000年5月间，对拟诊为呼吸系和／或泌尿系细菌感染的肾移植患者进行，取其痰，咽拭子或中段尿标本进行细菌培养并作24种常用抗生素药敏试验，对结果进行统计学分析。结果：共有653份标本培养结果阳性，其中痰标本233份，咽拭子173份，中段尿247份，主要阳性菌株是铜绿假单胞菌，肺炎克雷伯杆菌，大肠杆菌和表皮葡萄球菌等。敏感率较高的抗生素有万古霉素，亚胺培南，阿米卡星和头孢他啶等，耐药率较高的有青霉素，氨苄西林，红霉素，苯唑西林和头孢唑林等。结论：（1）肾移植后感染的主要菌株种类与其他患者有所不同；（2）肾移植患者的感染菌株对抗生素敏感率最高的依次为万古霉素，亚胺培南，阿米卡星和头孢他啶，但耐药性也正在逐渐增强（3）肾移植患者的感染主要发生在呼吸和泌尿系统，其他部位的感染少见；（4）痰和咽拭子来源的细菌株对抗生素更敏感，中段尿来源的细菌则耐药株相对多见。

Investigation on the bacteria spectrum of infection sufferer after renal transplantation and study on their resistance to antibiotics

Objective To further increase the successful rate of clinically treating infection following renal transplantation.Methods Specimens including spit, pharynx mop and mid urine were collected from April 1997 to May 2000 from post transplantation inpatients who suffered from bacterial infections. Bacterial culture and sensitivity test to antibiotics were undertaken.Results Of the 653 specimens presenting positive results, 233 were spit specimens, 173 pharynx mop specimens and 247 mid urine specimens, respectively. The major positive strains were Bacillus pyocyaneus, Klebsiella pneumoniae, Escherichia coli and Staphylococcus epidermidis. The following antibiotics were more effective: Vancomycin, Imipenem, Amikacin and Ceftazidime; while those with higher resistant ratio were Penicillin, Ampicillin, Erythromycin, Oxacillin and Cefazolin.Conclusions The species of major strains in renal transplant patients are different from other kinds of patients; The bacterial strains resulting in infections of renal transplant patients are relatively sensitive to antibiotics, but their resistant rate are gradually increased; Most of the infections in renal transplant patients occur in respiratory and urological system; The strains from spit and pharynx are more sensitive to antibiotics, but those from mid urine are relatively more resistant to antibiotics.