Kawecki D, Chmura A, Pacholczyk M, Lagiewska B, Adadynski L, Wasiak D, Malkowski P, Sawicka-Grzelak A, Rokosz A, Szymanowska A, Swoboda-Kopec E, Wroblewska M, Rowinski W, Durlik M, Paczek L, Luczak M
Department of General Surgery and Transplantation, Transplantation Institute, Medical University of Warsaw, Poland.
Transplant Proc. 2007 Nov;39(9):2807-11. doi: 10.1016/j.transproceed.2007.08.044.
We estimated the frequency and susceptibility to antibacterial agents of bacterial isolates from bile samples obtained from 83 liver recipients in the early period after transplantation.
We prospectively collected data on 83 adult patients undergoing orthotopic liver transplantation (OLT), including bile samples taken during the first 30 days after OLT from adult liver recipients suspected to have bile infections. The isolation/identification of cultured bacteria was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was determined according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.
Among 210 bile samples obtained from 79 liver recipients, bacterial cultures were positive in 110 samples from 59 (75%) recipients yielding 156 bacterial strains. The most commonly isolated species were as follows: gram-positive cocci (109 isolates) with dominance of coagulase-negative staphylococci (52%) and enterococci (36%); and gram-negative bacteria, 21 strains from the Enterobacteriaceae family and 14 of non-fermenting rods. We identified some multidrug-resistant (MDR) bacterial strains. In the first week after OLT, we investigated samples from 59 patients, yielding 36 bacterial strains. From the second to the end of the fourth week after OLT, 120 bacterial strains were isolated from 65 recipients.
Gram-positive bacteria comprised 68.5%. The dominance of MDR gram-positive bacteria may be related to selection by perioperative antibiotic prophylaxis.
我们评估了83例肝移植受者移植早期胆汁样本中分离出的细菌菌株对抗菌药物的频率和敏感性。
我们前瞻性收集了83例接受原位肝移植（OLT）的成年患者的数据，包括OLT术后前30天内从疑似有胆汁感染的成年肝移植受者采集的胆汁样本。培养细菌的分离/鉴定按照标准微生物学程序和市售检测方法进行。根据临床和实验室标准协会（CLSI）指南测定菌株对抗菌药物的敏感性。
在从79例肝移植受者获得的210份胆汁样本中，59例（75%）受者的110份样本细菌培养呈阳性，共培养出156株细菌菌株。最常分离出的菌种如下：革兰氏阳性球菌（109株），以凝固酶阴性葡萄球菌（52%）和肠球菌（36%）为主；革兰氏阴性菌，21株来自肠杆菌科，14株为非发酵菌。我们鉴定出了一些多重耐药（MDR）细菌菌株。在OLT术后第一周，我们检测了59例患者的样本，培养出36株细菌菌株。从OLT术后第二周直到第四周结束，从65例受者中分离出120株细菌菌株。
革兰氏阳性菌占68.5%。多重耐药革兰氏阳性菌占优势可能与围手术期抗生素预防的选择有关。
