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肝移植术后感染的发生率及危险因素:哥伦比亚波哥大圣菲德基金会大学医院的单中心经验

Incidence and risk factors for infections after liver transplant: single-center experience at the University Hospital Fundación Santa Fe de Bogotá, Colombia.

作者信息

Vera A, Contreras F, Guevara F

机构信息

Transplant Service, University Hospital Fundación Santa Fe de Bogotá, Santa Fe de Bogotá, Colombia.

出版信息

Transpl Infect Dis. 2011 Dec;13(6):608-15. doi: 10.1111/j.1399-3062.2011.00640.x. Epub 2011 Jul 28.

Abstract

The incidence of infections in liver transplant patients is higher compared with recipients of other organs, and infections are one of the major complications after transplantation. The aim of our study was to evaluate the incidence, presentation and risk factors of infections in liver transplant recipients in a Latin-American population, and to compare the results with data worldwide. We performed a retrospective analysis of 94 consecutive patients undergoing liver transplantation between 2004 and 2008 at the University Hospital Fundación Santa Fe de Bogotá, Colombia. The patients contributed a total of 64.4 person years (PY). Fifty-two patients (55.3%) developed one or more infections, in total 83 events (128.9 infections/100 PY). Bacterial infections represented the most frequent event (71.1%), followed by viral (19.3%) and fungal infections (8.4%). In 1%, no causative organism was identified. More than one-third of infections (37%) occurred during the first 30 days, whereas 83% of all events were seen during the first 6 months. The most common site of pathogen localization was the bloodstream (25.3%), followed by the urinary tract (15.7%), liver with bile tract (14.5%), abdomen (10.8%), surgical site (7.2%), and lungs (9.6%). The overall mortality after 1 year was 14.9%, and 57.1% of the deaths were attributed to infections. We found that risk factors significantly associated with increased incidence rate ratio for infection were prolonged stay at the intensive care unit, the need for parenteral nutrition, and blood transfusion requirement. Our data provide additional information about etiology and epidemiology of infections after liver transplantation.

摘要

与其他器官移植受者相比,肝移植患者的感染发生率更高,且感染是移植后的主要并发症之一。我们研究的目的是评估拉丁美洲人群中肝移植受者感染的发生率、表现及危险因素,并将结果与全球数据进行比较。我们对2004年至2008年在哥伦比亚波哥大圣菲德基金会大学医院连续接受肝移植的94例患者进行了回顾性分析。这些患者共贡献了64.4人年(PY)。52例患者(55.3%)发生了一种或多种感染,共83起事件(128.9例感染/100 PY)。细菌感染是最常见的事件(71.1%),其次是病毒感染(19.3%)和真菌感染(8.4%)。1%的感染未发现致病微生物。超过三分之一的感染(37%)发生在术后前30天,而83%的事件发生在术后前6个月。病原体最常见的定位部位是血流(25.3%),其次是尿路(15.7%)、肝及胆道(14.5%)、腹部(10.8%)、手术部位(7.2%)和肺部(9.6%)。1年后的总体死亡率为14.9%,5

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