肾移植术后医院尿路感染病原菌及危险期研究

Study of pathogenic bacteria and critical days about urinary tract hospital infection after renal transplantation

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。

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.