Kawecki D, Kwiatkowski A, Michalak G, Sawicka-Grzelak A, Mlynarczyk A, Sokol-Leszczynska B, Lazinska B, Dzieciatkowski T, Przybylski M, Czerwinski J, Lisik W, Bieniasz M, Wszola M, Domagala P, Rowinski W, Durlik M, Luczak M, Chmura A, Mlynarczyk G
Department of Medical Microbiology, Transplantation Institute, Medical University of Warsaw, 5 Chalubinskiego street, 02-004 Warsaw, Poland.
Transplant Proc. 2009 Oct;41(8):3143-7. doi: 10.1016/j.transproceed.2009.07.066.
This study evaluated the frequency of microbial isolates and their susceptibility profiles among cultures from the "surgical site" of 26 simultaneous pancreas-kidney (SPKT) recipients in the early posttransplant period.
Data on microbiologic cultures of 26 adult patients undergoing SPKT were collected prospectively from 2001 to the end of 2006. The isolation and identification of cultured micro-organisms was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was made by the Clinical and Laboratory Standards Institute (CLSI) guidelines.
All patients were followed prospectively for the first 4 weeks after surgery yielding 168 microbial isolates from the surgical site. The most commonly isolated organisms were Gram-positive bacteria (65.5%) with domination of staphylococci (52.7%) as methicillin-resistant S aureus and methicillin-resistant coagulase-negative staphylococci. The second most common were enterococci (33.6%) with the presence of an high level aminoglycoside-resistant strains (64.9%) and vancomycin-resistant strains (2.7%). Gram-negative bacteria comprised 19% of positive cultures; among them were isolated extended spectrum beta-lactamase producers and carbapenem-resistant strains. Yeast-like fungi comprised 15.5% of positive cultures. In conclusion, we observed predominantly Gram-positive bacteria, comprising 65.5% of isolates. The increased proportion of multi-drug-resistant bacterial isolates may be due to the frequent prophylaxis of bacterial infections in patients.
本研究评估了26例同期胰腺-肾脏移植（SPKT）受者移植后早期“手术部位”培养物中微生物分离株的频率及其药敏谱。
前瞻性收集了2001年至2006年底26例接受SPKT的成年患者的微生物培养数据。按照标准微生物学程序和市售检测方法进行培养微生物的分离和鉴定。菌株对抗菌药物的敏感性依据临床和实验室标准协会（CLSI）指南确定。
所有患者术后前4周均接受前瞻性随访，共从手术部位分离出168株微生物。最常分离出的微生物是革兰氏阳性菌（65.5%），其中葡萄球菌占主导（52.7%），包括耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌。第二常见的是肠球菌（33.6%），其中存在高水平氨基糖苷类耐药菌株（64.9%）和耐万古霉素菌株（2.7%）。革兰氏阴性菌占阳性培养物的19%；其中分离出了产超广谱β-内酰胺酶菌株和耐碳青霉烯类菌株。酵母样真菌占阳性培养物的15.5%。总之，我们观察到主要为革兰氏阳性菌，占分离株的65.5%。多重耐药细菌分离株比例增加可能是由于患者频繁预防性使用抗菌药物所致。
