肾移植术后尿路感染病原菌及抗感染治疗方案分析

Analysis of infection pathogens and anti-infection treatment of urinary tract infection after renal transplantion

目的:探讨肾移植术后尿路感染的发生时间、主要病原菌、耐药性及抗感染治疗方案,为临床诊治提供参考。方法:将2013年1月-2015年12月因肾移植术后尿路感染来某院就诊的59例患者作为研究对象,对其临床资料进行回顾性分析。结果:肾移植术后尿路感染的发生时间主要集中在术后6个月内,占88.14%。病原体主要为细菌和病毒,其中革兰阴性菌感染42例,占65.63%,革兰阳性菌感染11例,占17.19%,巨细胞病毒感染8例,占12.50%,真菌感染3例,占4.69%。经验性抗感染治疗药物主要包括哌拉西林他唑巴坦、头孢哌酮舒巴坦等。结论:肾移植术后尿路感染的发生率较高,需引起重视,应根据患者的具体情况,合理用药,提高治愈率。

OBJECtiVE To explore the infection time, main pathogens, drug resistance and anti-infection treatment of uri- nary tract infection after renal transplantion to guide the clinical diagnosis and treatment. METtIODS Fifty nine cases of urina- ry tract infection after renal transplantion from January 2013 to December 2015 in our hospital were retrospectively analyzed. ~TS The time of urinary tract infection was mainly concentrated in 6 months after renal transplantion, accounting for 88. 14~. The bacteria and viruses were the main pathogens, including 42 cases （65.63~） with gram-negative bacterial infec- tions, 11 cases （17. 19%） with gram-positive bacterial infections, 8 cases （12. 50%） with CMV infections, 3 cases （4. 69~） with fungal infection. Empirical anti-infection drugs included piperacillin-tazobactam, cefoperazone-sulbactam etc. CONCLU- SION The incidence of urinary tract infection after renal transplantion is high, which should be highly considered with further effective prevention measures. It is necessary for the hospital to reasonably use anti-infection drugs according to the patients＂ own conditions to improve the cure rate.