Diagnosis and treatment of severe pulmonary infection in patients after kidney transplantation / 解放军医学杂志

ABSTRACT

Objective To study the diagnosis and treatment of the severe pulmonary infection in the patients after kidney transplantation. Methods The clinical data of 26 patients with severe pulmonary infection following kidney transplantation were analyzed retrospectively. Results Microorganisms were isolated and identified in 22 patients out of 26 kidney transplantation patients with severe pulmonary infection. The main etiological pathogens according to their frequency and type were bacteria (15 cases, including Escherichia coli, Aerobacter cloacae, Klebsiella fredlanderi, Enterococcus faecalis, Staphylococcus epidermidis, etc.), fungi (12 cases, Fermentum, Blastomyces albicans, Candida tropicalis, Aspergillus, etc.), and cytomegalovirus (10 cases). 46.15% (12/26) of patients were infected with one kind of microorganism, and 53.85% (14/26) of patients were mixed infection. In 73.1% (19/26) of patients the pulmonary infection occurred during 1-6 months after renal transplantation. Among 26 patients, 12 developed ARDS, and 4 patients gave up therapies due to high expenses. With energetic treatment, 18 patients (81.82%) were cured and 4 died. Conclusions Intensive care and active measures should be given in the treatment of severe pulmonary infection after kidney transplantation. Early diagnosis, administration of broad-spectrum and combined use of antibiotics, the early identification of pathogens, enforcement in systemic support, including correction of immunosuppression, the timely use of mechanical ventilation to correct hypoxia, are the key treatment strategies for a successful result.