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单中心实体器官移植术后早期多重耐药菌感染的临床特征。

Clinical features of multidrug-resistant organism infections in early postoperative solid organ transplantation in a single center.

机构信息

Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Ann Palliat Med. 2021 Apr;10(4):4555-4562. doi: 10.21037/apm-21-777.

Abstract

BACKGROUND

The increasing occurrence of multidrug-resistant organisms (MDROs) infections has posed major challenge to solid organ transplantation (SOT). For SOT recipients, high-dose immunosuppressants and broad-spectrum antibiotics can markedly increase the risk of early postoperative MDRO infections and thus have adverse effects on the outcomes of SOT. Here, we analyzed the incidence and clinical features of early MDRO infections after SOT, in an attempt to provide new evidence for the control and treatment of early MDROs.

METHODS

The clinical data of 133 patients with MDRO infections after SOT in our department from 2017 to 2020 were retrospectively collected, and clinical features including incidence, etiologies, infection sites, and complications, were analyzed.

RESULTS

The incidence of MDRO infections after SOT was 9.9%. Simultaneous liver and kidney transplantation patients had the highest incidence of MDRO infections, followed by the recipients of liver transplantation and simultaneous pancreas-kidney transplantation; patients undergoing renal transplantation had the lowest incidence of MDRO infections. The most common pathogen was extended spectrum beta-lactamase (ESBL)-producing organisms (n=88, 66.2%), the most common infection site was the urinary system (n=58, 43.6%), and the main postoperative complications were urinary tract infections (n=44, 33.1%) and lung infections (n=41, 30.8%). MDRO infections were cured in most cases.

CONCLUSIONS

A sound knowledge of the clinical features of MDRO infection after SOT is important for the successful prevention and treatment of these infections.

摘要

背景

多药耐药菌(MDRO)感染的发生率不断增加,对实体器官移植(SOT)构成了重大挑战。对于 SOT 受者,大剂量免疫抑制剂和广谱抗生素会显著增加术后早期 MDRO 感染的风险,从而对 SOT 的结果产生不利影响。在这里,我们分析了 SOT 后早期 MDRO 感染的发生率和临床特征,试图为早期 MDRO 的控制和治疗提供新的证据。

方法

回顾性收集了 2017 年至 2020 年我科 133 例 SOT 后 MDRO 感染患者的临床资料,分析了包括发生率、病因、感染部位和并发症在内的临床特征。

结果

SOT 后 MDRO 感染的发生率为 9.9%。同时肝、肾移植患者 MDRO 感染发生率最高,其次为肝移植患者,同时胰肾移植患者发生率最低;肾移植患者 MDRO 感染发生率最低。最常见的病原体是产超广谱β-内酰胺酶(ESBL)的病原体(n=88,66.2%),最常见的感染部位是泌尿系统(n=58,43.6%),术后主要并发症是尿路感染(n=44,33.1%)和肺部感染(n=41,30.8%)。大多数情况下 MDRO 感染得到治愈。

结论

了解 SOT 后 MDRO 感染的临床特征对于成功预防和治疗这些感染非常重要。

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