Analysis and clinical significance of culture results of donor renal perfusate / 中华器官移植杂志

ABSTRACT

Objective To study the culture results of renal graft cold storage solution and therapeutic strategies.Methods This study retrospectively studied the bacterial culture,drug sensitivity test and fungal culture results of donor kidney preservation fluid in 172 cases in our hospital from February 2016 to December 2017.The prevention and treatment strategies of our hospital,and relevant literatures retrieved were comprehensively analyzed.Results Positive culture results were found in 13.4％ (22/172) cases.Among them,17 cases were positive for bacteria,including 1 case positive for Stenotrophomonas maltophilia,2 for Enterococcus faecium,2 for Acinetobacter baumannii (1 case of extensive drug resistance),4 for Klebsiella pneumoniae (2 cases of extensive drug resistance),1 for Klebsiella oxytoca,3 for Escherichia coli (2 expressing extended-spectrum beta-lactamase),1 for Enterobacter cloacae,1 for Staphylococcus epidermidis,1 for both Enterococcus faecium and Klebsiella pneumoniae,1 for both Escherichia coli expressing extendedspectrum beta-lactamase and Klebsiella pneumoniae.Three cases were positive for fungi,including 2 for Canidia albicans and 1 for Candida krusei.Two cases were positive for both bacteria and fungi,including 1 for Candida tropical and Enterococcus faecium,1 for Candida glabrata and Klebsiella pneumoniae with extensive drug resistance.One recipient died of serious cardiac arrhythmia on the 32nd day after implantation with positive results of Stenotrophomonas maltophilia.One recipient positive for Candida tropicalis fecal faecium had graft nephrectomy because of rupture of renal artery at day 14 after implantation.The remaining 15 and all culture-negative cases had good graft outcome during 6 months of follow-up.Conclusion Culture of renal graft cold storage fluid as well as targeted prevention and treatment strategies based on positive results can effectively reduce the incidence of infectious vascular complications in recipients.