肾移植术后肺部感染患者病原体及危险因素分析

doi:10.3969/j.issn.1006-6233.2021.02.022

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Abstract Objective: To investigate the characteristics, pathogen spectrum and risk factors for pulmonary infection in kidney transplant recipients. Methods: We performed a retrospective cohort study reviewing the medical records of 627 patients who had undergone kidney transplantation at The Second Affiliated Hospital Of Guangzhou Medical University from April 2017 to April 2019. Results: One hundred and five(16.75%)patients developed pulmonary infection during the follow-up period. Five cases(4.76%)of pulmonary infection occurred within 1month after surgery, sixty-one cases(58.10%)occurred within 2～6 months and 39 cases(37.14%)occurred more than 6 months after surgery, respectively. Among 105 patients, 70 patients had been detected positively with pathogens. The pathogens isolated from sputum and blood sampls accounted for 89.33%, isolated from throat swab and pleural effusion sampls accounted for 10.67%, respectively. The pathogens identified in 70 patients indicated that 54 (55.10%) cases were bacteria, 16 (16.33%) were fungus, 12 (12.24%) were cytomegalovirus, 1(1.02%)was pneumocystis carinii and 15 (15.31%) were complicated infection. The most common organisms were Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Stenococcus maltophilia and Staphylococcus aureus. Univariate analysis demonstrated that diabetes history(P=0.044), WBC＜4×10⁹L^-1(P=0.015), delayed graft function (P=0.008)and acute rejection(P=0.037)were risk factors of pulmonary infection in kidney transplant recipients. Multivariate logistic regression analysis showed that WBC＜4×10⁹L^-1(OR=2.499,95%CI 1.321～4.726, P=0.005), delayed graft function(OR=2.894,95%CI 1.128～7.429, P=0.027) and acute rejection(OR=2.233,95%CI 1.121～4.446, P=0.022)were independent risk factors associated with the development of pulmonary infection in kidney transplant recipients. Conclusion: Pulmonary infection most commonly occurs within 2～6 months after kidney transplantation. Collecting various samples from different sites and combination of different detection methods can increase the detection rate of pathogens. The patients who have WBC＜4×10⁹L^-1, delayed graft function or acute rejection after kidney transplantation are at increased risk of developing pulmonary infection.

Key words： Kidney transplantation Pulmonary infection Pathogen Risk factor

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	DENG Cong
	SUN Weimin
	LIN Meishuang
	et al

Cite this article:

DENG Cong,SUN Weimin,LIN Meishuang, et al. An Analysis of Pathogen Spectrum and Risk Factors for Pulmonary Infection in Kidney Transplant Recipients[J]. HeBei Med, 2021, 27(2): 279-283.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.02.022 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I2/279

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