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肾移植受者的细菌性尿路感染及其抗生素耐药模式:一项为期四年的研究。

Bacterial urinary tract infection in renal transplant recipients and their antibiotic resistance pattern: A four-year study.

作者信息

Khosravi Azar Dokht, Abasi Montazeri Effat, Ghorbani Ali, Parhizgari Najmeh

机构信息

Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran ; Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Iran J Microbiol. 2014 Apr;6(2):74-8.

Abstract

BACKGROUND AND OBJECTIVE

Urinary tract infections (UTIs) are the most common infections in renal transplant recipients and are considered a potential cause of bacteremia, sepsis, and affects graft outcomes. The aim of the present study was to determine the incidence of UTI among renal transplant recipients and investigation of antimicrobial susceptibility pattern of causative agents.

MATERIALS AND METHODS

In total, 1165 patients from March 2009 to December 2012, in transplant center of Golestan Hospital, Ahvaz, Iran, were investigated. Qualitative urine cultures were performed for all cases, causative microorganisms were identified and colony count was performed according to the standard protocol. Antibiotic susceptibility testing was then performed to determine the susceptibility pattern of recovered bacteria from confirmed UTIs.

RESULTS

UTI was diagnosed in 391 patients(33.56%). Gram-negative bacteria were the most prevalent isolated microorganisms with E. coli (43.53%), followed by Enterobacter spp. (35.37%) as the major organisms. Among Gram positives, Coagulase-negative Staphylococci was isolated from 6.8% of cases. The rate of resistance to all tested antibiotics was highest in Enterobacter spp., however the most common resistance were seen against cefixime, cephalotin, and cotrimoxazole in all tested gram negatives.

CONCLUSION

the rate of UTIs among renal transplant recipients was noticeable in this study with high antibiotic resistance. Multi-resistant bacterial infections are potentially life-threatening emerging problem in renal transplantation. Prophylactic measures must be applied to patients at greater risk.

摘要

背景与目的

尿路感染(UTIs)是肾移植受者中最常见的感染,被认为是菌血症、败血症的潜在病因,并会影响移植结果。本研究的目的是确定肾移植受者中UTI的发生率,并调查病原体的抗菌药敏模式。

材料与方法

对2009年3月至2012年12月期间伊朗阿瓦士戈勒斯坦医院移植中心的1165例患者进行了调查。对所有病例进行定性尿培养,鉴定致病微生物,并按照标准方案进行菌落计数。然后进行抗生素药敏试验,以确定确诊UTI患者中分离出的细菌的药敏模式。

结果

391例患者(33.56%)被诊断为UTI。革兰氏阴性菌是最常见的分离微生物,其中大肠杆菌(43.53%)最为常见,其次是肠杆菌属(35.37%)。在革兰氏阳性菌中,凝固酶阴性葡萄球菌在6.8%的病例中被分离出来。肠杆菌属对所有测试抗生素的耐药率最高,然而在所有测试的革兰氏阴性菌中,最常见的耐药情况是对头孢克肟、头孢噻吩和复方新诺明耐药。

结论

本研究中肾移植受者的UTI发生率较高,且抗生素耐药性也较高。多重耐药细菌感染是肾移植中一个潜在的危及生命的新出现问题。必须对高危患者采取预防措施。

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