肠道CRE筛查对肾移植患者继发感染的预警价值

Early warning value of intestinal CRE screening for secondary infection in renal transplant patients

目的探讨肠道耐碳青酶烯类肠杆菌(CRE)筛查对肾移植患者继发感染的预警价值。方法对某院2019年度进行肠道CRE筛查的肾移植患者,后期继发感染及预后情况进行回顾性分析。结果48例肾移植患者进行了肠道CRE筛查,其中2例检出CRE,且均为耐碳青酶烯类肺炎克雷伯菌(CRKP),后期均发生CRKP血流感染且治疗效果不佳。筛查为阴性的患者46例,其中手术切口CRKP感染1例,其余5例病原菌均为非CRE菌株,且阴性组6例感染患者均为一过性感染,经治疗后康复。结论对肾移植患者肠道有CRE特别是CRKP定植时,应警惕继发感染的反复发生,且提示预后不良。

Objective To investigate the early warning value of intestinal Carbapenem-Resistant Enterobacteriaceae(CRE)screening for secondary infection in renal transplant patients.Methods Retrospective analysis was conducted on the subsequent infection and prognosis of renal transplant patients undergoing intestinal CRE screening in a hospital in 2019.Results Forty-eight patients with renal transplant were screened for intestinal CRE,and 2 of them were found to be CRE,both were Carbapenem-Resistant Klebsiella Pneumoniae(CRKP).All of them developed bloodstream infection of CRKP in the later stage and had poor therapeutic effect.Among the 46 patients with negative screening,1 was infected with CRKP at the surgical incision,and the other 5 were all infected with non-CRE strains.In addition,all the 6 infected patients in the negative group were transient infections and recovered after treatment.Conclusion When intestinal CRE,especially CRKP,is engrafted in renal transplant patients,the recurrence of secondary infection should be warned,and the poor prognosis should be notified.