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肾移植后第一年发生尿路感染的危险因素。

Risk factors for urinary tract infections during the first year after kidney transplantation.

作者信息

Sorto R, Irizar S S, Delgadillo G, Alberú J, Correa-Rotter R, Morales-Buenrostro L E

机构信息

Department of Nephrology and Mineral Metabolism, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, DF, Mexico.

出版信息

Transplant Proc. 2010 Jan-Feb;42(1):280-1. doi: 10.1016/j.transproceed.2009.11.029.

Abstract

INTRODUCTION

Urinary tract infections (UTI) have been reported to occur with frequencies ranging from 30% to 60% in kidney transplant recipients during the first year posttransplantation. UTI is the main cause of infectious complications in this period. The objective of this study was to evaluate the incidence of UTI, during the first year posttransplantation and to identify the risk factors associated with its development, as well as its impact on graft function.

PATIENTS AND METHODS

This retrospective cohort study had as a primary outcome the development of UTI, defined as the presence of more than 100,000 colony-forming units (CFU) of a pathogenic organism by mL of urine. The univariate analysis was performed with chi-square test for categorical variables and Student t test for continuous ones metrics. We performed multivariate analysis with logistic regression. P < .05 was considered statistically significant.

RESULTS

We studied 176 kidney transplant recipients, including 54.5% of male gender and with an overall average age of 37 +/- 12 years. The UTI incidence was of 35.8% (n = 63). The bacterium most frequently found in urine cultures was Escherichia coli (n = 46). In this study, the risk factors that were independently associated with UTI development were age, female gender, days of bladder catheterization, genitourinary anatomic alterations, and UTI during 1 month prior to kidney transplantation.

CONCLUSION

This type of study makes it possible to identify risk factors and to formulate strategies focused on particular risk factors.

摘要

引言

据报道,肾移植受者在移植后的第一年发生尿路感染(UTI)的频率在30%至60%之间。UTI是这一时期感染性并发症的主要原因。本研究的目的是评估肾移植后第一年UTI的发生率,确定与其发生相关的危险因素,以及其对移植肾功能的影响。

患者与方法

这项回顾性队列研究的主要结局是UTI的发生,定义为每毫升尿液中致病生物体的菌落形成单位(CFU)超过100,000个。对分类变量采用卡方检验进行单因素分析,对连续变量采用学生t检验进行分析。我们使用逻辑回归进行多因素分析。P < 0.05被认为具有统计学意义。

结果

我们研究了176例肾移植受者,其中男性占54.5%,总体平均年龄为37±12岁。UTI发生率为35.8%(n = 63)。尿培养中最常发现的细菌是大肠杆菌(n = 46)。在本研究中,与UTI发生独立相关的危险因素是年龄、女性性别、膀胱插管天数、泌尿生殖系统解剖改变以及肾移植前1个月内的UTI。

结论

这类研究能够识别危险因素,并制定针对特定危险因素的策略。

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