Abdo-Cuza Anselmo A, Gómez-Bravo Miguel A, Pérez-Bernal Jose B, Suárez-López Juliette, Gómez-Peire Francisco, Leiva-Torres Jorge L, Bejerano-Gil Nilda, Leal-Alpizar Geydy, Espinosa-Nodarse Namibia, Castellanos-Gutiérrez Roberto
Servicio Medicina Intensiva, Centro de Investigaciones Médico Quirúrgicas, Havana, Cuba.
Servicio de Trasplantes, Hospital Virgen del Rocío, Seville, Spain.
Transplant Proc. 2020 Mar;52(2):509-511. doi: 10.1016/j.transproceed.2019.12.010. Epub 2020 Feb 5.
Health care-associated infection (HAI) represent a global health problem with an increase in hospital stays, deaths, and monetary costs. Recipients of solid organ transplants are a population at risk. The objectives of the study were to characterize the incidence of HAI in renal and hepatic transplant recipients as well as to compare them with the population without transplants in intensive care units (ICU).
The data on the incidence of HAI, localization, microorganisms, and demographics were taken from the patients admitted between the years 2013 to 2018 (n = 4307) from the registration of the Project for the Reduction of Nosocomial Infection in Intensive Care Units. The variables were compared with those of renal transplant (n = 96) and liver transplants (n = 68) recipients.
Renal transplant recipients showed 26% incidence of HAI. The most frequent were surgical site infection (SSI), urinary tract infection, and primary bacteremia; the most frequent microorganism was Staphylococcus spp, mortality 3.8%. Liver transplant recipients showed 41% incidence of HAI. The most frequent were tracheobronchitis associated with mechanical ventilation, SSI, and primary bacteremia; the most frequent microorganism was Staphylococcus spp, mortality 37%. The population without transplants in the ICU showed 17% incidence of HAI. The most frequent were respiratory infections associated with mechanical ventilation, primary bacteremia, and SSI; the most frequent microorganism was Acinetobacter spp, mortality 21%.
HAI in recipients of solid organ transplants (renal and hepatic) have a higher incidence than in a population without transplants. The location and causal microorganisms have particularities that must be taken into account for the development of prevention protocols.
医疗保健相关感染（HAI）是一个全球性的健康问题，会导致住院时间延长、死亡人数增加以及金钱成本上升。实体器官移植受者是一个高危人群。本研究的目的是描述肾移植和肝移植受者中HAI的发生率，并将其与重症监护病房（ICU）中未接受移植的人群进行比较。
关于HAI的发生率、感染部位、微生物以及人口统计学数据取自2013年至2018年间入住ICU的患者（n = 4307），这些数据来自重症监护病房医院感染减少项目的登记记录。将这些变量与肾移植受者（n = 96）和肝移植受者（n = 68）的变量进行比较。
肾移植受者中HAI的发生率为26%。最常见的是手术部位感染（SSI）、尿路感染和原发性菌血症；最常见的微生物是葡萄球菌属，死亡率为3.8%。肝移植受者中HAI的发生率为41%。最常见的是与机械通气相关的气管支气管炎、SSI和原发性菌血症；最常见的微生物是葡萄球菌属，死亡率为37%。ICU中未接受移植的人群中HAI的发生率为17%。最常见的是与机械通气相关的呼吸道感染、原发性菌血症和SSI；最常见的微生物是不动杆菌属，死亡率为21%。
实体器官移植（肾和肝）受者中的HAI发生率高于未接受移植的人群。感染部位和致病微生物具有特殊性，在制定预防方案时必须予以考虑。
