肾移植前后的菌群变化与临床的相关性研究

The study of relationship between the change of microbial population pre-and post-renal transplantation and clinical infection

目的 研究肾移植前后的菌群变化及其与临床感染的相关性。方法 随机选取 16 9例肾移植患者 ,检测移植前后菌群变化 ,观察术后切口感染率及各种细菌、真菌感染的发生率。其中随机选取 84例于肾移植术中、术后使用西力欣 ,另 85例术后使用青霉素或头孢拉啶预防感染。结果 (1)术前菌群按检测频率由高到低为 :草绿色链球菌、卡他双球菌 ,大肠艾希氏杆菌 ,变形杆菌 ,肺炎克雷伯杆菌 ,嗜血流感杆菌 ,枸橼酸杆菌 ,铜绿假单胞杆菌 ,金黄色葡萄球菌 ,肺炎双球菌 ,白色念珠菌 ;(2 )术后肺部感染菌群出现频率由高到低为 :肺炎克雷伯杆菌 ,嗜血流感杆菌 ,大肠艾希氏杆菌 ,枸橼酸杆菌 ,阴沟杆菌 ,金黄色葡萄球菌 ,肺炎双球菌 ,肺炎链球菌 ,粪链球菌 ,肠球菌 ,真菌为念珠菌属 ,青霉菌 ,隐球菌及曲霉菌。 (3)术后切口感染率为 3 %。结论 肾移植前菌谱与术后感染菌谱有一定相关性 ,适当抗生素的使用对于降低术后感染率有重要作用。

Objective To study the relationship between the change of microbial population pre and post renal transplantation and clinical infection. Methods 169 patients undergoing renal transplantation were randomly selected to determine the microbial population pre and post transplantation and to observe the incision infection rate and bacteria and fungas local or systemic infection rate. 84 cases of them received Cefuroxime and remaining 85 cases received Peniciline or Cephradine as control group. Results The microbial population before transplantation included (in a order of high frequency to low frequency): streptococcus viridans, Branhamella catarrhalis, escherichia coli, proteus vulgaris, mirabilis, Klelsiella pneumoniae, haemophilus influenzae, citrobacter secies, pyocyaneus aeruginosa, staphylococcus aureus, micrococcus lanceolatus, candida albicans. The microbial population of lung infection after transplantation contained (in a order of high frequency to low frequency) Klelsiella pneumoniae, haemophilus influenzae, escherichia coli, citrobacter secies, bacillus cloacae, staphylococcus aureus, micrococcus lanceolatus, streptococcus pneumoniae ,streptococcus faecalis, enterococcus faecalis. Fungas population was consisted of candida, penicillium marneffei, cryptococcus neoformans ,aspergillus fumigatus fresenius. Incision infection rate was 3?%. Conclusions There was some positive relationship between the change of microbial population pre and post renal tranplantation and clinical infection. The use of antibiotic around renal transplantation might decrease infection rate.