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新型免疫抑制剂时代的尿路感染:一项三级医疗中心研究

Urinary tract infections in the era of newer immunosuppressant agents: a tertiary care center study.

作者信息

Khanna Pallavi, Abraham Georgi, Mohamed Ali Asik Ali, Miriam Prathiba Evelyn, Mathew Milly, Lalitha M K, Lesley Nancy

机构信息

Pondicherry Institute of Medical Sciences, Madras Medical Mission, Chennai, India.

出版信息

Saudi J Kidney Dis Transpl. 2010 Sep;21(5):876-80.

Abstract

We studied the incidence and the risk factors predisposing to post transplantation urinary tract infection (UTI) and the association with use of different immunosuppressive regimens. We performed a retrospective analysis of 152 recipients of renal transplantation over a period of two years. Seventy one (46.71%) patients had culture positive UTI, Escherichia coli (45.1%) being the commonest. Thirty four (22.39%) patients had acute rejection and 14.4% of those had suffered UTI in the early post transplant period. Immunosuppression included induction with various antibodies and maintenance on antirejection medications. Trimethoprim-sulphamethoxazole was given as prophylaxis throughout the period. The UTI was treated according to microbiological sensitivity. 2.8% died due to urosepsis. In our retrospective analysis renal transplant recipients under the age of 45, female gender and diabetics suffered more UTI. Combination therapy with micro-emulsion form of cyclosporine A, prednisolone and azathioprine developed more UTI (P= 0.0418).

摘要

我们研究了肾移植术后尿路感染(UTI)的发生率、易感危险因素以及与不同免疫抑制方案使用之间的关联。我们对两年内152例肾移植受者进行了回顾性分析。71例(46.71%)患者尿培养阳性,其中大肠埃希菌最为常见(占45.1%)。34例(22.39%)患者发生急性排斥反应,其中14.4%在移植后早期发生UTI。免疫抑制包括使用各种抗体进行诱导治疗以及使用抗排斥药物进行维持治疗。在此期间全程给予复方新诺明进行预防。根据微生物敏感性对UTI进行治疗。2.8%的患者死于尿脓毒症。在我们的回顾性分析中,45岁以下的肾移植受者、女性和糖尿病患者发生UTI的情况更多。环孢素A微乳剂、泼尼松龙和硫唑嘌呤联合治疗发生UTI的情况更多(P = 0.0418)。

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