Clinical study of early infection of multi-drug resistant organisms after renal transplantation from organ donation after citizen's death
10.3969/j.issn.1674-7445.2017.05.010
- VernacularTitle:公民逝世后器官捐献肾移植早期多重耐药菌感染的临床研究
- Author:
Zhibin LI
1
;
Geng ZHANG
;
Kepu LIU
;
Dongli RUAN
;
Long GAO
;
Huilong WANG
;
Wenfeng ZHENG
;
Shuaijun MA
;
Weijun QIN
;
Jianlin YUAN
Author Information
1. 第四军医大学西京医院泌尿外科
- Keywords:
Renal transplantation;
Donation after citizen's death;
Donation after cardiac death;
Multi-drug resistant bacteria;
Infection;
Escherichia coli;
Urinary system;
Kidney graft infection;
Pulmonary infection;
Bacteremia
- From:
Organ Transplantation
2017;8(5):386-391
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics, prevention and treatment of multi-drug resistant organisms (MDROs) infection early after renal transplantation from donation after citizen's death. Methods Clinical data of 166 patients undergoing allogeneic renal transplantation and regular follow-up in Xijing Hospital from November 2011 to September 2016 were retrospectively analyzed. General conditions were statistically compared between the recipients undergoing renal transplantation from donation after cardiac death (DCD) and their counterparts receiving living related donor renal transplantation. The incidence of MDROs infection, onset time, course of diseases, complications, infection site and etiological type were observed. The therapeutic methods and clinical prognosis were summarized. Results The incidence of MDROs infection early after renal transplantation in the recipients undergoing DCD renal transplantation was 14%, significantly higher than 2% in those receiving living related donor renal transplantation, and 13% and 2% for the incidence of delayed graft function with statistical significance (both P<0.05). The incidence of renal graft loss was 8%and 2%, and 5% and 1% for the mortality rate without statistical significance between two groups (both P>0.05). MDROs infection occurred in 11 patients after DCD renal transplantation. The most common infection site was urinary system(n=6) and the most prevalent pathogenic bacterium was Escherichia coli (n=4). All patients infected with MDROs were treated with a sufficient dosage of effective antibiotics according to the outcomes of bacterial culture and drug sensitivity test. Eight patients obtained favorable clinical prognosis, one underwent nephrectomy and two died. Conclusions The incidence of MDROs infection early after DCD renal transplantation is higher than that after living related-donor renal transplantation. Strict donor screening, early detection, intimate monitoring and timely treatment can effectively reduce the risk of MDROs and enhance clinical prognosis.
