异体肾移植术后早期尿路及手术部位感染模式

Bhajan Kumar Saha, Md. Habibur Rahman, T. S. Hossain, Faruk Hossain, K. Ghosh
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摘要

肾移植(KT)提供了显著的生存效益,是终末期肾病患者唯一的治愈治疗方法。感染并发症仍然是移植患者发病和死亡的主要原因。本研究旨在评估同种异体活体肾移植受者移植后早期尿路和手术部位感染的微生物和危险因素。本观察性随访研究于2019年7月至2020年12月在达卡BSMMU泌尿外科选择20例接受同种异体肾移植手术的患者进行。有肾移植史或先天性肾异常和任何泌尿系统恶性肿瘤的患者被排除在研究之外。肾移植后,6例(30%)肾移植受者发生尿路感染,均为复杂类型,发生于术后10 ~ 14天。3例(15%)患者为大肠杆菌,1例(5%)患者为克雷伯菌,2例(10.0%)患者为肠球菌。3例(15%)肾移植受者发生SSI,其中2例为浅表,1例为深部。SSI发生于术后5-8天。2例(10%)由金黄色葡萄球菌引起,1例(5%)由假单胞菌引起。尿路感染在年龄较大和置管时间较长的患者中明显增加。老年患者和超重患者的SSI发生率明显较高。总体而言,33%的患者在住院早期出现尿路感染,且均为复杂类型。15%发生SSI,其中2/3为浅表,1/3为深部。年龄越大、置管时间越长、DJ支架放置时间越长与UTI的发生有关,年龄越大、BMI越高与SSI的发生有关。Bsmmu j 2022;15 (2): 127 - 131
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Pattern of urinary tract and surgical site infection in allograft renal recipient during early postoperative period
A kidney transplant (KT) offers a significant survival benefit and is the only curative treatment for patients with ESRD. Infectious complications are still a leading cause of morbidity and death among transplant patients. This study aimed to assess the organisms and risk factors responsible for urinary tract and surgical site infection in allograft live-related renal transplant recipients during the early post-transplant period. This observational follow-up study was conducted among 20 purposively selected patients who underwent renal allograft transplant surgery from July 2019 to December 2020 in the Department of Urology, BSMMU, Dhaka. Patients with a history of renal transplant recipients or congenital renal anomalies and any urological malignancy were excluded from the study. After kidney transplant, UTI developed in 6 (30%) renal transplant recipients where all were complicated types and occurred between 10 to 14 days postoperatively. UTI was caused by E. coli in 3 (15%) patients, while Klebsiella and Enterococci were causative organisms for 1 (5%) and 2 (10.0%) patients, respectively. SSI developed in 3 (15%) renal transplant recipients where two were superficial, and one was deep. SSI occurred between 5-8 days postoperatively. SSI was caused by S. aureus in 2 (10%) patients and Pseudomonas in 1 (5%) patient. UTI was significantly more in older patients and the patients with a longer duration of catheterization. Older patients and overweight patients had significantly higher rates of SSI. In total, 33% of the recipient during the early hospital stay developed UTIs, all of which were complicated types. SSI developed in 15%, where 2/3rd was superficial and 1/3rd was deep. Older age with a longer duration of catheterization and DJ stent was found to be associated with the occurrence of UTI, while older age and high BMI were related to the event of SSI. BSMMU J 2022; 15(2): 127-131
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