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胰肾联合移植术后手术部位感染的发生率及危险因素

Incidence and risk factors for surgical site infection after simultaneous pancreas-kidney transplantation.

作者信息

Perdiz L B, Furtado G H C, Linhares M M, Gonzalez A M, Pestana J O M, Medeiros E A S

机构信息

Hospital Epidemiology Committee, Division of Infectious Diseases, Federal University of São Paulo, Brazil.

出版信息

J Hosp Infect. 2009 Aug;72(4):326-31. doi: 10.1016/j.jhin.2009.04.016. Epub 2009 Jul 10.

Abstract

A simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for type I diabetic patients with advanced chronic renal failure. Infectious complications affect 7-50% of the patients receiving this procedure. We conducted a nested case-control study to assess the risk factors for surgical site infection (SSI) in patients receiving SPKT at our centre between 2000 and 2006. Of the 119 evaluated transplant recipients, 55 (46.2%) developed SSIs and the 30 day mortality was 11.8%. Gram-negative organisms were the predominant organisms isolated from SSIs. After multivariate logistic regression, the variables independently associated with SSI were: acute tubular necrosis, post-transplant fistula and graft rejection. This study demonstrated a high incidence of SSI in this patient cohort and variables related to the surgical procedure were closely associated with the development of SSI.

摘要

同期胰肾联合移植(SPKT)是晚期慢性肾衰竭I型糖尿病患者的最佳治疗选择。感染性并发症影响7%至50%接受该手术的患者。我们进行了一项巢式病例对照研究,以评估2000年至2006年在我们中心接受SPKT的患者手术部位感染(SSI)的危险因素。在119名接受评估的移植受者中,55名(46.2%)发生了SSI,30天死亡率为11.8%。革兰氏阴性菌是从SSI中分离出的主要细菌。经过多因素逻辑回归分析,与SSI独立相关的变量为:急性肾小管坏死、移植后瘘管和移植物排斥反应。本研究表明该患者队列中SSI的发生率很高,与手术相关的变量与SSI的发生密切相关。

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