[1]王坤英,张蓬杰a,王慧英,等.肾移植术后肺部感染时间、病原菌分布及耐药性分析[J].现代检验医学杂志,2016,31(05):97-99，102.[doi:10.3969/j.issn.1671-7414.2016.05.026]
　WANG Kun-ying,ZHANG Peng-jiea,WANG Hui-ying,et al.Analysis of the Onset Time,Pathogen Distribution and Drug Resistance in Kidney Transp-Lant Patients with Lung Infection[J].Journal of Modern Laboratory Medicine,2016,31(05):97-99，102.[doi:10.3969/j.issn.1671-7414.2016.05.026]
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肾移植术后肺部感染时间、病原菌分布及耐药性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年05期
页码:
97-99，102
栏目:
论著
出版日期:
2016-10-21

文章信息/Info

Title:
Analysis of the Onset Time,Pathogen Distribution and Drug Resistance in Kidney Transp-Lant Patients with Lung Infection
文章编号:
1671-7414(2016)05-097-04
作者:
王坤英1; 张蓬杰2a; 王慧英1; 郝鸿雁1; 廉江平2b
1.山西省第二人民医院检验科,太原 030012;
2.陕西省人民医院 a.肾病血透中心;
b.药学部,西安 710068
Author(s):
WANG Kun-ying1; ZHANG Peng-jie2a; WANG Hui-ying1; HAO Hong-yan1; LIAN Jiang-ping2b
1.Department of Clinical Laboratory,the Second People's Hospital of Shanxi Province,Taiyuan 030012,China;
2a.the Center of Kidney Diseases and Hemodialysis;
2b.Pharmacy Department,Shaanxi Provincial People's Hospital,Xi'an710068,C
关键词:
肾移植;  肺部感染;  耐药性
分类号:
R699.2; R446.5
DOI:
10.3969/j.issn.1671-7414.2016.05.026
文献标志码:
A
摘要:
目的 了解肾移植术后肺部感染的发病时间、病原菌分布及耐药性特点,为临床治疗提供依据。方法 收集2012年1月～2015年12月共73例肾移植术后肺部感染患者的临床资料,回顾性分析感染发生的时间、标本分离的病原菌及耐药性结果,采用WHONET5.4软件对药敏结果进行分析。结果 73例肾移植术后肺部感染发生的时间在术后1年内占83.56%(61/73),其中39例发生于肾移植术后6月内,占53.42%(39/73),22例发生于术后6月～1年,占30.14%(22/73)。病原菌分离部位以痰液、血液为主,占84.93%(62/73),其余为肺泡灌洗液、胸腔引流液及咽拭子等。共分离出病原菌79株,革兰阴性杆菌39株(49.37%),革兰阳性菌31株(39.24%)及真菌9株(11.39%)。较常见的病原菌依次为:铜绿假单胞菌12株(15.19%),表皮葡萄球菌11株(13.92%),肺炎克雷伯菌10株(12.66%),金黄色葡萄球菌9株(11.39%),鲍曼不动杆菌8株(10.13%),大肠埃希菌6株(7.59%)。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶的检出率分别为30.0%(2/6)和20.0%(2/10)。表皮葡萄球菌和金黄色葡萄球菌中的耐甲氧西林葡萄球菌检出率分别为45.45%(5/11)和22.22%(2/9)。革兰阴性杆菌对头孢吡肟、美洛培南和亚胺培南敏感。革兰阳性球菌对万古霉素、替考拉丁和利福平敏感。结论 肾移植术后肺部感染多发生在术后1年内; 革兰阴性菌为主要的病原菌; 革兰阴性菌和革兰阳性菌常多重耐药,应尽早选用敏感药物治疗。
Abstract:
Objective To investigate the occurring time,pathogen distribution and drug resistance in kidney transplant patients with lunginfection and to provide basis for clinical treatment.Methods From January 2012 to December 2015,73 kidney transplant patients with lung infection were collected in this study.The timing of infection occurrence,the main source of specimen,the pathogenic bacteria and drug resistance of each case were analyzed retrospectively.The drug sensitivity was analyzed by WHONET 5.4 software.Results 83.56%(61/73)cases of lung infection occurred within 1 year in kidney transplant patients,among them,53.42%(39/73)cases occurred within 6 month after kidney transplantation,and 30.14%(22/73)cases occurred within 6～12 months after surgery.The 84.93%(62/73)source of specimen were sputum and blood,and the others were alveolar lavage fluid,pleural fluid and throat swab.Totally 79 strains of pathogenic bacteria wereisolated,including gram negative bacilli(49.37%), gram positive bacteria(39.24%)and fungi(11.39%). The most common strains were Pseudomonas aeruginosa 12 strains(15.19%),Staphylococcus aureus 11 strains(13.92%),Klebsiella pneumoniae 10 strains(12.66%),Staphylococcus aureus 9 strains(11.39%),Bauman Acinetobacter 8 strains(10.13%),and Escherichia coli6 strains(7.59%).The detection rate of strains which producing broad-spectrum β-lactamases were 30.0% in Escherichia colil and 20.0% in Klebsiella pneumonia,respectively.Furthermore,the detection rate of methicillin-resistant Staphylococcus were 45.45% in Staphylococcus epidermidisl and 22.22% in Staphylococcus aureus,respectively.The drug sensitivity resultsshowed that the Gram-negative bacilli were sensitive to Vancomycin,teicoplaninand rifampicin.The Gram-positive cocci were sensitive to Cefepime,meropenemand imipenem.Conclusion 83.56%(61/73)cases of lung infection occurred within 1 year in kidney transplant patients; Gram-negative bacteria were the main pathogenic bacteria in lung infection in kidney transplant patients; Gram-negative bacteria and Gram-positive bacteria were multi drug resistant and should be treated as early as possible.

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备注/Memo

备注/Memo:

作者简介:王坤英(1978-),女,硕士研究生,主管检验师,Tel:13834589871。
通讯作者:张蓬杰,E-mail: 13149254918@163.com。
更新日期/Last Update: 2016-10-30