Classification Of Pathogens Of Urinary Tract Infection After Renal Transplantation And Analysis Of Drug Resistance Characteristics Of Multidrug-resistant Bacteri

Research background and objectiveThe most authoritative replacement therapy for late stage of nephridium disease is kidney transplantation.The factors affecting the prognosis of renal transplantation have been widely studied in the past few years.The common factors that affect the prognosis of renal transplant recipients include acute rejection,immunosuppression,infection,diabetes,gender and so on.Infection related diseases are indicative of the survival rate after renal transplantation.Urinary system,lung,blood flow system and incision are common sites of infection after renal transplantation,and the most common site of infection is urinary system.This study collected the relevant data of patients with urinary tract infection after renal transplantation in the second hospital of Shandong University from 2017 to 2020,analyzed and summarized the types of germs related to urinary pathway infection after transfer and the related drug resistance,so as to provide help for clinical work.Research methodIn this retrospective study,the relevant data of patients with urinary tract infection after kidney transplantation in the second hospital of Shandong University from 2017 to 2020 were collected.The basic information(gender,age,frequency of infections,etc.),pathogenic species,drug sensitivity test results and other data of patients are summarized and analyzed by Excel and IBM spss26.Research resultsThis study showes that there are 534 renal transplant patients from 2017 to 2020,including 73 patients with urinary tract infection after kidney transplantation,and there are positive testimony of pathogen and positive consequences of drug sensitivity test;There are 119 pathogenic germs were detected,of which 75 are Gram-negative micro-organism,34 are Gram-positive germ and 10 are funguses.1.There are 119 strains of infectious bacteria cultured from urine samples after kidney transplantation,including 75 strains of 9 kinds of gram-negative bacteria.The top three pathogens are Escherichia coli(46 strains),Klebsiella pneumoniae(19 strains)and Proteus mirabilis(3 strains);A total of 34 strains of 6 kinds of gram-positive cocci are cultured;In addition,10 fungal infection were detected,including Candida near smooth muscle,Candida near smooth,Candida tropicalis,Candida glabrata,Candida albicans and so on.2.There are 41 strains of multi drug resistant bacteria in urinary tract infection after renal transplantation,and the gram-negative bacilli is first,including extended spectrum germ β-lactamase Escherichia coli and Klebsiella pneumoniae(27 strains and 6 strains respectively),Klebsiella pneumoniae of resistant carbapenem(1 strain),Proteus mirabilis(2 strains)and Burkholderia cepacia of extended spectrum β-lactamase(2 strains).Only 3 strains of multi medicine Enterococci are detected,all of which are methicillin resistant coagulase negative Staphylococcus epidermidis.3.The analysis of etiology and drug sensitivity suggests that the carbapenems(such as meropenem),piperacillin/tazobactam and amikacin are valid to muti-drug resistant Enteric bacillus or Escherichia coli;Besides being sensitive to the above drugs,E.coli is also highly sensitive to tegacyclin and cephalosporins,while multi drug resistant E.coli is highly resistant to them.For gram-positive cocci,Enterococcus faecium is principal.It is highly sensitive to vancocin and linezolid.In addition,it is also highly susceptibility to daptomycin.4.The detection rate and medicine resistance of familiar pathogen in urinary tract infection after nephridium transplantation:the detection rate of pathogenic bacteria related to urinary tract infection after renal transplantation in 2020 increases with the previous three years(P=0.045),but the detection rate of multi-drug resistant bacteria decreased compared with the previous three years(P=0.002);As well,it was also found that the resistance of gram-negative bacilli to cefepime was increasing,which was statistically significant(P=0.046).In addition,the study also found that the number of infections was correlated with urinary multi drug resistant bacterial infection(P=0.004),and other factors such as gender and days of hospitalization are no meaning statistically.Research conclusion1.The Gram-negative bacilli is the common pathogens of urinary tract infection after renal transplantation,and the Klebsiella pneumoniae and Escherichia coli is top two;Gram positive cocci followed,Enterococcus faecium is important.2.Extended spectrum beta-lactamase Enterobacter is the main pathogen associated with urinary multi-drug resistant bacteria infection after kidney transplantation,and ESBL producing Escherichia coli is the first.3.The study found that for non drug resistant Enterobacteriaceae and extended spectrumβ-For Enterobacteriaceae with lactamases,the resistance to carbapenems,amikacin and piperacillin tazobactam is low.The difference is that the former has low resistance to cephalosporins and tegacyclin in addition to the above drugs,while the latter has high resistance to these two drugs.Enterococcus faecium is susceptibility of Gram positive coccus,of which have inferior medicine resistance to vancocin and linezolid(ZYVOX).4.The culture rate of pathogen related to urinary tract germs infection after renal transplantation has an ascending trend,but the culture rate of multi drug resistant germs has a degressive tendency;The medicine resistance of gram-negative bacillus to cefepime increased,which was statistically significant.In addition,the study also found that there was a correlation between the times of infection and urinary multi drug resistant germ infection.