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肾移植术后医院尿路感染病原菌及危险期研究 |
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翁国斌 姚许平 胡勤勇 陈跃英 陈光耀1
摘要 目的：探讨肾移植术后医院尿路感染的病原菌谱及其危险因素和危险期。方法：定期监测76例肾移植患者术后尿液的病原菌情况，统计多种因素与尿路感染的病原菌谱和发生率的关系。结果：76例患者发生尿路感染30例，发生率为39.5%。分离出真菌16株(35.6%)，肠杆菌科菌14株(31.1%)，其他菌15株(33.3%)。术后5～17 d感染者24例，占感染总数的80.0%。结论：肾移植术后5～17 d是医院尿路感染的危险期。病原菌以真菌、肠杆菌科菌为主。急性排斥反应及其治疗、留置导尿管、广谱抗生素的应用等是影响病原菌谱及发生率的主要因素。
关键词 肾移植 医院感染 泌尿道感染 病原体
Study of pathogenic bacteria and critical days about urinary
tract hospital infection after renal transplantation
Weng Guobing Yao Xiuping Hu Qinyong et al
(Department of Urology,Yinxian People′s Hospital,Zhejiang,315040)
Abstract Purpose:To elucidate the pathogenic bacteria and hazards and critical days of urinary tract hospital infection after renal transplantation.Methods:To monitor regularly the pathogenic bacteria of urine in 76 cases during their hospitalizations after renal transplantation.The relations between multifactors and the pathogenic bacteria and the urinary tract infection rate were analysed statistically.Results:30 cases of 76 (39.5%) existed the urinary tract hospital infection.45 pathogenic bacteria were detected,among which 16 were fungi (35.6%),14 Enterobacteriaceae (31.1%),15 the others (33.3%).80.0% (24/30) infection occurred during 5 to 17 days after the transplantation.Conclusions:5～17 days after transplantation were critical days.The fungi and enterobacteriaceae were chief pathogenic bacteria.Acute rejection of the transplant kidney and the immunological management,indwelling catheter,broad-spectum antibiotics were main factors to influence the pathogenic bacteria and the infection rate.
Key words Kidney transplantation Hospital infections Urinary tract infection Pathogens
尿路感染是肾移植术后最常见的医院感染之一，随着肾移植技术的日趋完善，尿路感染也发生了新的变化。笔者对1996年10月～1998年10月76例同种异体肾移植患者进行了回顾性研究，现报告如下。
1 资料与方法
1.1 临床资料
肾移植患者76例，男48例，女28例，年龄17～67岁，平均40.5岁。供肾热缺血时间≤8 min，冷缺血时间≤16 h。平均手术时间2.4 h。术后应用CsA+Aza+Pred三联免疫抑制剂。住院30～[1] [2] [3] 下一页
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