OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in hospital-associated infections for patients after renal transplantation, and to provide a reference for the rational selection of antibacterial drugs for anti-infective treatment in such patients.

METHODS Clinical data were collected from 89 hospitalized patients who underwent renal transplantation and developed hospital-associated infection at Beidaihe Rehabilitation and Recuperation Center (formerly known as 281 Hospital) from 2017 to 2021. The pathogenic bacteria detected in different types of hospital-associated infections and the drug resistance of the main pathogenic bacteria were analyzed.

RESULTS A total of 89 pathogenic bacterial strains were isolated from the 89 patients with hospital-associated infection, including 74 gram-negative bacterial strains (83.15%) and 15 gram-positive bacterial strains (16.85%). The predominant pathogenic bacterial strains were Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa. Respiratory tract infection was the most common. E. coli showed severe drug resistance, with high drug resistance rates to various antibacterial drugs (complete drug resistance to piperacillin and ampicillin). K. pneumoniae was generally drug resistant to ampicillin. Enterobacter cloacae showed high sensitivity to carbapenems, amikacin and enzyme inhibitor combinations. P. aeruginosa had low drug resistance rates to imipenem and meropenem. Staphylococcus aureus was completely drug resistant to antibacterial drugs such as penicillin, erythromycin and gentamicin, and no drug-resistant strains to vancomycin and linezolid were found.

CONCLUSIONS The gram-negative bacteria are dominant among the bacteria isolated from the renal transplanted patients with postoperative hospital-associated infections, with a high detection rate of E. coli and a severe drug resistance situation. Therefore, it is necessary to strengthen the monitoring of drug resistance in renal transplant recipients and make rational choices of antibacterial drugs.