肾移植术后医院感染病原菌及抗感染治疗方案分析

目的：探讨肾移植术后住院期间感染的发生率、主要病原菌、耐药性及抗感染治疗方案，为临床诊治提供参考。方法：将2014年1月~2015年12月进行肾移植术的184例患者作为研究对象，对其临床资料进行回顾性分析。结果：肾移植受者术后感染发生率为18.48%（34/184），包括泌尿系感染（21例，61.76%），肺部感染（8例，23.53%），伤口感染（3例，8.82%）。病原体主要为细菌和病毒，其中革兰阴性菌感染16例，占47.06%，革兰阳性菌感染7例，占20.59%，巨细胞病毒感染5例，占14.71%，真菌感染2例，占5.88%。经验性抗感染药物主要为哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南等。结论：肾移植术围手术期感染的发生率较高，须引起重视，应根据患者的具体情况合理用药，提高感染治愈率。

Analysis of Nosocomial Infection Pathogens and Anti-infection Treatment after Renal Transplantation

O bjective: To explore the infection rate, main pathogens, drug resistance and anti-infection treatment after renal transplantation so as to guide the clinical diagnosis and treatment. Method: A total of 184 cases of renal transplant patients from January 2014 to December 2015 in our hospital were retrospec-tively analyzed. Results: The infection rate after renal transplantation was 18.48% (34), including urinary tract infections (21, 61.76%), pulmonary infections (8, 23.53%) and wound infections (3, 8.82%). The bac-teria and viruses were the main pathogens: there were 16 cases (47.06%) with gram-negative bacterial in-fections, 7 cases (20.59%) with gram-positive bacterial infections, 5 cases (14.71%) with CMV infections and 2 cases (5.88%) with fungal infections. Empirical anti-infection drugs included piperacillin-tazobactam, cefoperazone-sulbactam, imipenem, etc. Conclusion: The incidence of nosocomial infection was high after renal transplantation, which should be highly considered with further effective prevention measures. It is necessary for the hospital to reasonably use anti-infection drugs according to the patients' individual condi-tion, so as to improve the cure rate.