Analysis of the Onset Time,Pathogen Distribution and Drug Resistance in Kidney Transp-Lant Patients with Lung Infection / 现代检验医学杂志

ABSTRACT

Objective To investigate the occurring time,pathogen distribution and drug resistance in kidney transplant pa-tients with lung infection and to provide basis for clinical treatment.Methods From January 2012 to December 2015,73 kid-ney 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 7 9 strains of pathogenic bacteria were isolated,including gram negative bacilli (49.37%),gram positive bacteria (39.24%)and fungi (11.39%).The most com-mon strains were Pseudomonas aeruginosa 12 strains (15.19%),Staphylococcus aureus 11 strains (13.92%),Klebsiella pneumoniae 10 strains (12.66%),Staphylococcusaureus 9 strains (11.39%),BaumanAcinetobacter 8 strains (10.13%), and Escherichia coli 6 strains (7.5 9%).The detection rate of strains which producing broad-spectrumβ-lactamases were 30.0% in Escherichiacolil and 20.0% in Klebsiellapneumonia,respectively.Furthermore,the detection rate of methicillin-resistant Staphylococcus were 45.45% in Staphylococcusepidermidisl and 22.22% in Staphylococcusaureus,respectively. The drug sensitivity results showed that the Gram-negative bacilli were sensitive to Vancomycin,teicoplanin and rifampicin. The Gram-positive cocci were sensitive to Cefepime,meropenem and 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.