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肾移植受者的菌尿症和肾脏感染

Bacteriuria and renal infection in kidney-transplant recipients.

作者信息

Thomsen O F, Hansen H E

出版信息

Acta Pathol Microbiol Scand B. 1977 Dec;85B(6):449-54. doi: 10.1111/j.1699-0463.1977.tb02001.x.

Abstract

In 64 patients who had undergone renal transplantation, later on followed by bilateral nephrectomy, bacterial growth culture was performed from the original kidneys. The presence of bacteria in the nephrectomy specimens was compared with the occurrence of significant bacteriuria before transplantation and in the period between transplantation and nephrectomy. Bacteria could be cultured from the nephrectomy specimens of 18 (28.1 per cent) of the patients, almost exclusively confined to cases of obstructive chronic pyelonephritis, analgesic nephropathy and congenital renal disease. Before transplantation, bacteriuria had been recorded in 34.4 per cent of the patients, most frequently in the three groups of diseases just mentioned. Between the transplantation and nephrectomy, bacteriuria occurred in 75.0 per cent of the patients. Patients with E. coliuria before transplantation were particularly liable to have E. coliuria also after the transplantation and to E. coli in the nephrectomy specimens, whereas patients in whon E. coliuria did not occur until in the post-transplantation period were less susceptible to E. coli infection involving the kidneys. Probably the presence of bacteria in the nephrectomy specimens is related to the primary disease rather than to immunosuppressive and antiobiotic agents administered in the post-transplantation period.

摘要

对64例接受肾移植后又接受双侧肾切除术的患者,对其原肾进行细菌生长培养。将肾切除标本中的细菌存在情况与移植前及移植与肾切除之间显著菌尿的发生情况进行比较。18例(28.1%)患者的肾切除标本可培养出细菌,几乎均局限于梗阻性慢性肾盂肾炎、镇痛剂肾病和先天性肾病患者。移植前,34.4%的患者有菌尿记录,最常见于上述三组疾病患者。在移植与肾切除之间,75.0%的患者发生菌尿。移植前有大肠杆菌尿的患者在移植后尤其容易再次出现大肠杆菌尿且肾切除标本中有大肠杆菌,而移植后才出现大肠杆菌尿的患者对涉及肾脏的大肠杆菌感染较不敏感。肾切除标本中细菌的存在可能与原发性疾病有关,而非与移植后使用的免疫抑制剂和抗生素有关。

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