肝移植术后感染病原菌分布及耐药性分析

Analysis of Distribution and Drug Resistance of Pathogens Isolated from Postoperative Infections after Liver Transplantation

目的了解肝移植术后感染的病原菌分布及耐药率，为临床治疗提供参考。方法对90例肝移植患者术后送检的各类标本中分离出的162株病原菌的分布及耐药性进行回顾性分析。结果90例肝移植患者中，感染发生率为55．6％，最常见的菌种依次为凝固酶阴性葡萄球菌（11．7％），铜绿假单胞菌（11．1％），肺炎克雷伯菌（9．9％），嗜麦芽寡养单胞菌（9．9％），念珠菌（8．6％）。病原菌具有高耐药的特点，而且呈现泛耐药现象，碳青霉烯类的耐药率在逐年上升，万古霉素与利奈唑胺仍是革兰氏阳性球菌最有效的抗菌药物。结论加强肝移植患者术后的病原菌分离及耐药性监测，合理选用抗菌药物，对肝移植术后预防和治疗感染有重要作用。

Objective To study the main pathogens and their drug resistance of postoperative infections after liver transplantation. Methods The distribution and drug resistance profile of 162 strains of bacterial isolates from various specimens in 90 liver transplantation inpatients were retrospectively analyzed. Results The incidence of infections after liver transplantation was 55.6%. The distribution of bacteria included 105 Gram negative bacilli （64.8%）, 43 Gram positive cocci （26.5%） and 14 Candida （8.6%）. The most common pathogens were coagulase negative Staphylococci （CNS）,Pseudomonas aeruginosa,Klebsilla pneumoniae,Stenotrophomonas maltophilia and Candida. The bacteria had the character of multidrug-resistance and high drug-reslstance,the resistant to carbopenems rate was growing. The most effective antibiotics to Gram positive cocci are still the Vancomycin and Linezolid. Conclusion Most of pathogens isolated from postoperative infections after liver transplantation are antibiotics resistant, and pathogen monitoring should be emphasized. This epidemiology of bacterial infections can help clinical therapy. It should be reasonable to apply antibiotics for decreasing the production of drug resistance.