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[肾移植后第1个月泌尿系统感染分析。诺氟沙星短期预防的价值]

[Analysis of urinary infection in the 1st month after kidney transplantation. Value of short prophylaxis with norfloxacin].

作者信息

Jasovich A, Vázquez L, Cassetti I, Barclay C, Cavalli N H, López Blanco O, Stamboulian D

机构信息

Departamento de Infectología y Medicina Preventiva, Sanatorio Güemes, Buenos Aires, Argentina.

出版信息

Enferm Infecc Microbiol Clin. 1990 Oct;8(8):496-500.

PMID:2095261
Abstract

Urinary tract infection is the most common complication in the first month after renal transplant, and it is associated with rejection and relapses. In addition, it is the leading cause of gram negative bacilli bacteremia. In a program of continuous epidemiological surveillance from March 1979 to October 1988, we evaluated the urinary tract infections in the first month after renal transplant, considering the following variables: duration of bladder catheterization, urologic complications, type of immunosuppression and preoperative and postoperative antibiotic prophylaxis. There were no differences between the development of urinary tract infections in relation with the duration of bladder catheterization (7 vs 4 days), the reduction of urologic complications (21 vs 6%), or with the introduction of cyclosporin to the conventional immunosuppressive regimen. However, when the group of 46 patients receiving postoperative antibiotic prophylaxis (norfloxacin 800 mg/day every 12 h during the time of vesical catheterization less than or equal to 4 days) was compared with the 147 without postoperative antibiotic prophylaxis, the rate of urinary tract infection in the first month was 8.7% vs 32.8%, respectively (p less than 0.01). Short-term prophylaxis with norfloxacin was a useful regimen, with good oral tolerance and a similar therapeutic efficacy as the sustained regimens reported in the literature.

摘要

尿路感染是肾移植后第一个月最常见的并发症,且与排斥反应及复发相关。此外,它是革兰氏阴性杆菌菌血症的主要原因。在1979年3月至1988年10月的一项连续流行病学监测项目中,我们评估了肾移植后第一个月的尿路感染情况,考虑了以下变量:膀胱插管持续时间、泌尿系统并发症、免疫抑制类型以及术前和术后抗生素预防。在尿路感染的发生与膀胱插管持续时间(7天对4天)、泌尿系统并发症的减少(21%对6%)或与将环孢素引入传统免疫抑制方案之间没有差异。然而,当将46例接受术后抗生素预防的患者组(在膀胱插管时间小于或等于4天期间,每12小时给予诺氟沙星800毫克/天)与147例未接受术后抗生素预防的患者组进行比较时,第一个月的尿路感染率分别为8.7%和32.8%(p小于0.01)。诺氟沙星短期预防是一种有用的方案,口服耐受性良好,治疗效果与文献报道的持续方案相似。

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