Objective: To compare the characteristics of urinary tract infection (UTI) between kidney transplant recipients and non-recipient patients.
Methods: Forty-nine kidney transplant recipients with UTI (69 episodes) and 401 non-recipient patients with UTI (443 episodes) admitted in Nanfang Hospital from January 2003 to August 2014 were enrolled in the study. The characteristics of UTI were compared between two groups.
Results: In both groups of UTI, female patients comprised a greater proportion (63.3% and 58.6%) and Escherichia coli was the most common pathogen isolated (37.7% and 34.1%). However, the infection rate of Klebsiella pneumonia in recipients was higher than that in non-recipients (11.6% vs 3.2%, P= 0.001), while the infection rate of Candida albicans was lower (1.5% vs 11.3%, P=0.008) than that in non-recipients. Recipients were likely to develop antibiotic resistance and with a higher recurrence rate than non-recipient patients (38.8% vs 16.7%, P<0.001). Compared to non-recipient UTI patients, the symptoms of urinary irritation in recipient UTI patients were more common. There was higher percentage of neutrophil granulocyte (72.65% ± 1.90% vs 68.59% ± 0.73%, P=0.048), lower proportion of lymphocytes (17.73% ± 1.27% vs 21.28% ± 0.61%, P=0.037), and less platelets [(187.64 ± 10.84) × 10(9)/L vs (240.76 ± 5.26) × 10(9)/L, P<0.01] in recipients than in non-recipient UTI patients.
Conclusion: These results indicate that the characteristics of UTI in kidney transplantation recipients and non-recipients patients are different.
目的: 分析肾移植受者与普通患者泌尿系统感染(UTI)的不同,探究肾移植受者UTI的合理诊治方案。
方法: 对2003年1月至2014年8月在南方医院确诊UTI的肾移植受者和普通患者进行回顾性分析,比较两组患者UTI特点。
结果: 49例肾移植受者共发生69次UTI,401例普通UTI患者共发生443次UTI;肾移植受者和普通UTI患者均以女性居多(63.3%和58.6%),大肠埃希菌感染频率均最高(37.7%和34.1%);两组UTI患者其他病原体易感性不一致:肾移植受者肺炎克雷伯杆菌频率高于普通患者(11.6%与3.2%, P=0.001),而白色念珠菌频率低于普通患者(1.5%与11.3%, P=0.008);肾移植受者尿路刺激征更多见,更易发生抗生素耐药,感染复发率更高(38.8%与16.7%, P<0.001);肾移植受者发生UTI时外周血中性粒细胞百分率高于普通患者[(72.65±1.90)%与(68.59±0.73)%, P=0.048],淋巴细胞百分率[(17.73±1.29)%与(21.28±0.61)%, P=0.037)]和血小板计数[(187.64±10.84)×10 9/L与(240.76±5.26)×10 9/L, P<0.01]均低于普通患者。
结论: 肾移植受者与普通患者UTI的特点不尽相同,早期行中段尿培养、合理使用抗生素、及时调整免疫抑制剂剂量对于肾移植受者UTI的防治具有重要意义。