[Early postoperative infections after liver transplantation--pathogen spectrum and risk factors].
[Early postoperative infections after liver transplantation--pathogen spectrum and risk factors].
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肝移植术后早期感染——病原菌谱及危险因素[J].
DOI：
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发表时间：
1996
影响因子：
2.6
通讯作者：
F. Mühlbacher
中科院分区：
文献类型：
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作者：
P. Götzinger;Thomas Sautner;P. Wamser;B. Gebhard;M. Barlan;R. Steininger;R. Függer;F. Mühlbacher
肝移植术后早期感染的发生导致发病率和死亡率显著上升。回顾性分析248例279眼角膜原位移植的临床资料。55.6%的患者在术后住院期间发生一次或多次细菌和/或真菌感染。细菌/真菌感染的中位发病时间为移植后第7天。肠球菌（42例）、铜绿假单胞菌（38例）、葡萄球菌（37例）、大肠埃希菌（17例）和白色念珠菌（11例）是最常见的微生物。74例（29.8%）患者发生病毒感染。巨细胞病毒（CMV）感染20例（8.1%），单纯疱疹病毒（HSV）感染32例（12.9%），水痘带状疱疹病毒（VZV）感染6例（2.4%）。14例（5.6%）患者同时发生CMV和VZV感染。1例患者发生CMV、HSV和VZV三重感染。对潜在危险因素的统计分析显示，血容量替代对预后有显著影响（p < 0.001）和至少一个排斥期的发生（p < 0.02）主要细菌/真菌感染和免疫抑制（P < 0.001）、冷缺血时间（P < 0.04）、至少一个排斥期的发生（P < 0.005）和病毒感染的血容量替代（P < 0.04）。
Infections occurring during the early postoperative phase after liver transplantation result in a significant rise in morbidity and mortality. The records of 279 orthoptic transplantations performed in 248 patients were analyzed retrospectively. 55.6% of all patients suffered from one or more episodes of bacterial and/or fungal infection during their postoperative hospitalisation. The median onset of bacterial/fungal infection was on day 7 after transplantation. Enterococci (42 episodes), Pseudomonas aeruginosa (38 episodes), staphylococci (37 episodes), Escherichia coli (17 episodes) and Candida albicans (11 episodes) were the most frequently detected organisms. 74 (29.8%) patients developed viral infections. 20 patients (8.1%) showed infection with cytomegalovirus (CMV), 32 patients (12.9%) with herpes simplex virus (HSV) and 6 patients (2.4%) with varicella zoster virus (VZV). 14 patients (5.6%) developed infection with both CMV and VZV. Triple infection with CMV, HSV and VZV occurred in one patient. Statistical analysis of potential risk factors showed a significant influence of blood volume replacement (p < 0.001) and occurrence of at least one rejection period (p < 0.02) for major bacterial/fungal infection and immunosuppression (p < 0.001), cold ischemic time (p < 0.04), occurrence of at least one rejection period (p < 0.005) and blood volume replacement (p < 0.04) for viral infection.