肝移植术后病原微生物分布及药物敏感性分析

目的　研究肝移植术后感染特点 ,提高肝移植病人围手术期成活率。方法　通过留取的痰、血、咽拭子标本的细菌和真菌结果 ,分析 164例病人肝移植术后病原微生物分布及其药物敏感性。结果　 164例肝移植病人术后有 10 0例 (61.0 %)病人送检的标本培养阳性 ,94株G-杆菌中以阴沟杆菌 (2 1株 )、产气肠杆菌 (19株 )和肺炎克雷伯杆菌 (17株 )最多见 ,亚胺培南和美洛培南对G-菌敏感性最好 (95 .7%～ 96.8%) ,头孢吡肟、环丙沙星、舒普深和特治星敏感性较好。 5 5株G 菌中表皮葡萄球菌 (2 5株 )和金黄色葡萄球菌 (14株 )为主 ,对万古霉素和替考拉宁敏感(10 0 %)。 2 5株真菌中以白色念珠菌 (16株 )和光滑念珠菌 (7株 )为主。结论　肝移植术后早期使用敏感抗生素是提高围手术期成活率措施之一 ,同时应调整免疫抑制剂方案。

The distribution and antibiotic susceptibility of pathogenic microorganism in liver allograft recipients

Objective To look into the characteristics of infections after orthotopic liver transplantation,so as to improve the survival of liver allograft recipients.Methods The clinical data of 164 patients,who received liver transplantation in our center from January 2002 to April 2004,were reviewed retrospectively.The microbiological results of sputum,blood and pharynx swab samples,and the antibiotic susceptibility of these pathogenic microorganisms was analyzed.Results 100 (61%) out of 164 cases of liver allograft recipients were found to be pathogenic microorganism positive in their samples.There were total 94 strains of G - bacilli found,among which Enterobacter cloacae,Enterobacter aerogenes and klebsiella pneumoniae were most frequently seen.G -bacilli were most sensitive to Imipenem and Meropenem (95.7-96.8%).Cefepime,Ciprofloxacin Sulperazone and Tazocillin were also effective in killing G -bacilli.There were total 55 strains of G bacilli found,among which Staph.Epidermidis and Staph.aureus were most frequently seen.These bacteria were sensitive to Vancomycin and Teicoplanin (100%).25 strains of fungi,mainly Candida albicans and Candida glabrate,were found.Conclusion Early application of effective antibiotics to liver allograft recipients helps to improve the survival of these patients,and the immunosuppressive regime should be adjusted accordingly. [