肾移植术后受者肺部感染的病原菌分布及耐药性分析.docVIP

肾移植术后受者肺部感染的病原菌分布及耐药性分析 瞿亚红，宋文慧，周程程，范明亮* （浙江省宁波市泌尿肾病医院?鄞州第二医院，浙江宁波 315100） [摘要] 目的：了解我院肾移植术后受者肺部感染的病原菌分布及其耐药现状，为临床合理使用抗生素提供依据。方法：对我院2006年10月至2011年9月移植科送检的来自538例肾移植术后受者的痰标本进行常规微生物培养及药敏试验，对检测结果进行统计分析。结果：共检出病原菌197株，其中革兰氏阴性菌杆菌85株（43.15%），革兰氏阳性球菌59株（29.95%），真菌46株，其它7株。肺炎克雷伯菌占首位，其次分别为白假丝酵母菌及血浆凝固酶阴性葡萄球菌。药敏结果显示肺炎克雷伯菌对亚胺培南最为敏感（耐药率为0%），居第二位的白假丝酵母菌对氟康唑的耐药率为6.72%。感染菌多重耐药现象严重。结论：我院肾移植术后受者肺部感染的病原菌以革兰氏阴性菌杆菌为主，但真菌仍是引起肾移植术后受者肺部感染的一个重要因素。 【关键词】 肾移植术后受者；肺部感染；耐药性 Analysis of distribution and drug resistance of pathogens causing lung infecions in patients after renal transplantation QU Ya-hong,SONG Wen-hui,CHOU Chen-chen,FAN Ming-liang (Ningbo urological and Nephrotic Hospital?Yinzhou NO.2 Hospital,Ningbo 315100,Ningbo 315100,China) [Abstract] Objective:To investigate the distribution of pathogens and drug resistance in patients with lung infetions aftr renal transplantation.[Methods]This investigation was conducted n patients with lung infetions aftr renal transplantation from Octobor 2006 to September 2011 in our hospital. These specimens were routine bacterial culture、sensitivity test ，the results were analysisedA total of 197strains of pathogens were isolated from the 538 cases. Among them, 85 Gram-negative bacilli(43.15%), 59 Gram-positive cocci (29.95%), 46 fungus(23.35%) and 7（3.55%） other strains were identified. Of all, Klebsiella pneumoniae、Candida albicans and coagulase-negative staphylococci were the primary pathogens. The drug resistance of Klebsiella pneumoniae was the lowest to IMP,and the drug resistance rates of Candida albicans to fluconazole was 6.72%,and most of them were multi-drug resistant. Conclusion: Gram-negative bacilli are the major pathogens causing lung infecions in patients after renal transplantation.but the fungus is still an important factor in causing lung infecions in patients after renal transplantation. Key words: patients after renal transplantation; lung infetion; Resistance 随着肾移植技术的不断完善与新免于抑制剂的不断问世，肾移植患者的整体存活率明显调高，但由于大量免疫抑制剂的应用，患者处于低免疫状态，对各种