心脏死亡器官捐献肾移植术后受者泌尿道感染影响因素及病原学分析

Influencing factors and etiological characteristics of postoperative urinary tract infection in recipients undergoing renal transplantation of donation after cardiac death

  • 摘要: 目的 探讨心脏死亡后器官捐献(donation after cardiac death, DCD)供者供肾移植术后受者泌尿道感染率、影响因素及病原学特点,旨在为DCD供者供肾移植术后受者泌尿道感染制定相应预防和控制措施提供理论依据。方法 对山东第一医科大学第一附属医院2016年1月-2018年12月DCD供者供肾移植术后受者进行回顾性调查,收集患者的临床资料,采用单因素和多因素Logistic回归分析DCD供者供肾移植术后受者泌尿道感染影响因素及病原学的分布特点。结果 共监测375例DCD供者供肾移植受者,监测发生泌尿道感染60例,感染率16.00%。单因素分析结果显示:性别、年龄、糖尿病、留置导尿管天数、急性排斥反应、肾功能延迟恢复(delayed graft function,DGF)、尿白细胞计数是DCD供者供肾移植术后受者泌尿道感染的影响因素;多因素Logistic回归分析结果显示:留置导尿管天数、DGF是DCD供者供肾移植术后受者泌尿道感染的独立影响因素; 60例DCD供者供肾移植术后受者泌尿道感染尿标本共分离病原菌88株,其中革兰阴性菌78株占88.64%。结论 DCD供者供肾移植术后受者泌尿道感染率较高,影响因素多,临床应明确风险,早期采取综合干预措施,积极防治泌尿道感染。

     

    Abstract: OBJECTIVE To explore the incidence, influencing factors and etiological characteristics of postoperative urinary tract infection in recipients undergoing renal transplantation of donation after cardiac death(DCD) so as to provide theoretical basis for development of prevention measures for postoperative urinary tract infection in the recipients undergoing renal transplantation of DCD. METHODS A retrospective survey was conducted for the recipients who received the renal transplantation of DCD in the First Affiliated Hospital of Shandong First Medical University from Jan 2016 to Dec 2018, the clinical data were collected from the patients, and the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors and etiological characteristics of the postoperative urinary tract infection in the recipients undergoing the renal transplantation of DCD. RESULTS Of totally 375 recipients who received the renal transplantation of DCD, 60 had urinary tract infection, with the infection rate 16.00%.The univariate analysis showed that the gender, age, diabetes mellitus, duration of urinary catheter indwelling, acute rejection, delayed graft function(DGF) and urine white blood cell counts were the influencing factors for the postoperative urinary tract infection in the recipients undergoing renal transplantation of DCD.The multivariate logistic regression analysis indicated that the duration of urinary catheter indwelling and DGF were the independent influencing factors for the postoperative urinary tract infection in the recipients undergoing renal transplantation of DCD.Totally 88 strains of pathogens were isolated from urine specimens of 60 recipients undergoing renal transplantation of DCD, 78(88.64%) of which were gram-negative bacteria. CONCLUSION The incidence rate of postoperative urinary tract infection is high among the recipients undergoing renal transplantation of DCD, there are a variety of influencing factors, and it is necessary for the hospital to make clear of the risk factors and take comprehensive intervention measures in early state so as to control the urinary tract infection.

     

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