关键词:

肝移植, 细菌感染, 耐药性, 抗菌药物

Abstract:

Objective To study the bacterial distribution and drug resistance of postoperative infection in children after liver transplantation. Methods The data of pathogenic bacteria infection after liver transplantation in children aged 0⁃14 years from 2019 to 2021 in Tianjin First Central Hospital were retrospectively analyzed，and the distribution of pathogenic bacteria and drug sensitivity test results were statistically analyzed，and the changes of pathogenic bacteria distribution and drug resistance in three years were compared. Results During the study period from 2019 to 2021，a total of 917 specimens were submitted for examination，of which 553 were positive and 364 were negative ，with a positive rate of 60.3%. Among 4476 samples，1220 were positive，with a positive rate of 27.3%，mainly isolated from blood（45.1%），ascites（30.4%）and bile secretions（9.6%）. Among them， 633 gram⁃positive bacterial accounted for 51.9%，mainly Enterococcus and Staphylococcus epidermis，Enterococcus had a higher resistance rate to clindamycin and Staphylococcus had a higher resistance rate to penicillin . The drug resistance rates of Staphylococcus aureus to penicillin increased year by year，and the differences were statistically significant（P < 0.05）. Linezolid resistant Enterococcus faecium emerged in 2021. 527 strains of gram ⁃ negative bacteria accounted for 43.2%，mainly Klebsiella pneumoniae and Escherichia coli，the cefuroxime，ceftriaxone with high resistance. The drug resistance rates of Klebsiella pneumoniae to cotrimoxazole，Escherichia coli to levofloxa⁃ cin，and Pseudomonas aeruginosa to cefoperazone/sulbactam and aztreonam increased year by year，and the differ⁃ ences were statistically significant（P < 0.05）. 60 strains of fungi and other pathogenic bacteria accounted for 4.9%. Conclusion The risk of infection after liver transplantation in children is high，bacteria are mainly Gram⁃positivebacteria. The detection rate of Enterococcus faecalis，Pseudomonas aeruginosa and Acinetobacter baumannii com⁃ plex bacteria showed an increasing trend year by year.It is very important to monitor bacterial resistance to provide basis for rational selection of antibacterial drugs in clinical departments.

Key words: liver transplantation； , bacterial infections； , drug resistance； , antibacterial drugs