113例肝移植围术期感染分析

Analyses of Infection after Liver Transplantation in 113 Patients

目的分析肝移植围术期感染相关情况,为临床合理用药提供参考。方法调查并分析2009～2012年我院肝移植患者送检标本及病原菌培养和耐药的相关资料,尤其针对痰培养阳性病例的感染情况进一步分析。结果我院近三年肝移植术后平均感染率为45.1%,标本来源以痰培养为主,阴性菌最常见为肺炎克雷伯菌,阳性菌最常见为屎肠球菌。痰培养阳性病例中临床实际感染病例占24%,校正后总感染率28.3%。细菌总体耐药性较高,而且呈现多重耐药现象。结论肝移植患者病情复杂,术后尤其术后早期感染率较高,耐药情况普遍,尤其手术预防用药哌拉西林/他唑巴坦的耐药率高于医院感染平均耐药率,正确看待各种培养结果,根据病原菌分布及耐药情况用药合理选择抗菌药物非常重要。

ObjectiveTo analyze the prevalence of bacterial infection and drug sensitivity after liver transplantation so as to provide reference to effective clinical therapy. Methods A retrospective survey of 113 patients who underwent orthotopic liver transplantation was carried out. Results The reported total incidence of bacterial infection after liver transplantation was 45.1%, while the verified incidence was 28.3%. The major bacterials were Klebsiella pneumoniae and Enterococcus faecom. Multidrug-resistant was observed. Conclusion It is very important to prevent bacterial infection and use antibiotic rationaly. Selection of effective antibiotics according to etiologic data and resistance of bacterial can help prevent the occurance of drug resistant strains.