肝移植术后早期感染的病原学特点

Characteristics of infective pathogens in early Hver transplantation patients

目的研究肝移植受者术后早期细菌和真菌感染的流行病学特点。方法回顾性分析207例肝移植受者的临床资料。结果肝移植术后早期细菌和真菌感染性并发症的发生率为40．6％，感染死亡率为14．3％；感染部位以肺部最常见，发生率为33．3％，其次是血液和腹腔感染，发生率分别为12．1％和10．1％，泌尿系统、皮肤和神经系统较为少见；共分离出病原菌157株，以革兰阴性菌（74株，49．0％）、铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌等最为常见。革兰阳性菌56株（35．7％），真菌24株（15．3％）。结论肝移植受者术后早期容易发生感染性并发症，应加强预防，积极治疗，降低病死率。

Objective To study epidemiology of bacterial and fungal infection in early liver transplantation patients. Methods A retrospective survey was undertaken in 207 orthotopic liver transplantation patients from July 2004 to December 2006. Results The bacterial and fungal infection rate was40.6%, the mortality of infection was 14.3%. The lung（33.3%）, blood（12. 1%） and abdomen （ 10. 1% ） were the common sites of infection. There were 157 strains of pathogens isolated. Seventy-seven strains were gram-negative bacteria （49. 0% ） with Pseudomonas aeruginosa, Acinetobacter Baumannii and Stenotrophomonas maltophilia being the most common bacterial pathogens. Fifty-six strains were gram- positive bacteria （35.7%）, 24 strains were fungi （ 15. 3% ）. Conclusion The infective complications were common in patients with orthotopic liver transplantation at the early stage and it is necessary to strengthen prevention and early therapy.