Distribution and drug resistance characteristics of pathogens for infection after lung transplantation from 2010 to 2016
10.3760/cma.j.issn.0254-1785.2017.09.001
- VernacularTitle:242例肺移植受者的感染病原菌分布及耐药特征分析
- Author:
Xiaojun CAI
1
,
2
;
复旦大学附属华山医院
;
Huizhu SONG
;
Zheng JIAO
;
Yi LU
;
Zhidong ZANG
;
Xiuhong ZHANG
;
Jingyu CHEN
Author Information
1. 214023 江苏无锡,南京医科大学附属无锡市人民医院临床药学室
2. 复旦大学附属华山医院
- Keywords:
Lung transplantation;
Infection;
Pathogen;
Drug resistance
- From:
Chinese Journal of Organ Transplantation
2017;38(9):513-519
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the pathogen distribution and drug resistance condition in patients after lung transplantation so as to guide the reasonable use of antibiotics.Methods The clinical specimens from 242 lung transplantation patients in Wuxi People's Hospital between Jan.2010 to Dec.2016 were retrospectively analyzed.Among the 242 patients,182 were males and 60 were females with the average age of (52 ± 15) years old.Automatic analysis instrument VITEK-2 was applied for pathogen detection and K-B method was used to test drug resistance.Results From 2373specimens,1005 strains of pathogens were isolated and the detection rate was 42.35％ (1005/2373),in which gram-negative bacteria accounted for 81.79％ (822/1005).The specimens mainly resulted from sputum (76.19 ％) and bronchoalveolar lavage (19.76 ％).Among those strains,acinetobacter baumannii (28.76％),pseudomonas aeruginosa (16.62％),klebsiella pneumonia (14.33％),escherichia coli (5.57％) and Stenotrophomonas maltophilia (4.88％) ranked the top five species.Acinetobacter baumannii strains were highly resistant to most of antibiotic agents,with the drug resistant rate from 59.52％ to 100％,except cefperazone-sulbactam (＜ 50％).Pseudomonas aeruginosa strains were highly resistant to cefazolin,ceftriaxone,cefotetan,ampicillin,ampicillinsulbactam with the resistance rate of 80.24％-98.80％,while compared to other anibiotics with the resistance rate less than 50％.Stenotrophomonas maltophilia strains with intrinsic drug resistance to imipenem were sensitive to trimethoprim-sulfamethoxazole,cefperazone-sulbactam,piperacillintazobactam,levofloxacin,ciprofloxacin with the drug resistance rate of 12.24％,14.29％,32.65％,16.33％ and 18.37％ respectively.Klebsiella Klebsiella pneumoniae and escherichia coli,whose resistant rate to ceftazidime,cefperazone-sulbactam,piperacillin-tazobactam,aztreonam,amikacin and tobramycin was all less than 50％,were highly sensitive to imipenem,with the resistance rate of 24.31％ and 7.14％ respectively.Gram-positive bacteria were accounted for 9.35％,mainly Staphylococcus aureus,Staphylococcus haemolyticus and Staphylococcus epidemics,and drug resistant rate of them to vancomycin was all less than 20.00％.Fungi were accounted for 8.86％,mainly Candida albicans and Filamentous fungi,whose drug resistance rate to 5 antifungal drugs was less than 20.00％.The drug resistance rate of C.glabrata strains and C.krusei strains to fluconazole was 80.00％ and 100.00％,respectively.Conclusion The incidence of gram-negative bacteria infection and multiple bacterial strain infection in patients after lung transplantation is very high and the nonfermentation bacteria are highly resistant to multiple antibiotics.So,the rational antibiotics' use inclinical practice should be based on drug sensitivity results in order to improve the lung transplant recipients' survival rate.
