The epidemiological characteristics of the lung infection after liver transplantation_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 LIU Shuren , LUO Xiangrong , LOU Liming , YU Zhouyao , LI Zhuoliang.

The Liver Disease Center of The PLA,The 458th Hospital of The PLA. Guangzhou,Guangdong, 510602, ChinaCorresponding author：LIU Shu-ren,E-mail: Liushurenwell@163.com;

Corresponding author：

LIU Shuren, Email: Liushurenwell@163.com

Keywords：

Liver transplantation; Lung infection; Relative factor; Pathogen; Drug resistance

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Objective To explore the clinical epidemiological characteristics of the lung infection after orthotopical liver transplantation. Methods The clinical data included infection morbidity, mortality, infectious times and relative factors, clinical manifestations, the bacterial strains and distributions of the pathogens, the bacterial resistances of the 53 liver transplantation recipients from 2003.3～2006.12 were summarized and analyzed retrospectively. Results Among 53 recipients, 33 developed lung infectious and 6 died .The mobidity was 62.3% and mortality was 18.2%, with a OR of 1.0. Lung infection predominantly occurred in the first month, especially in the first week after transplantation.There were many factors related to lung infections.Various pathogens, especially Klebsialla, Escherichia Coli and Staphylococus Hominis were isolated from sputum, airway suction drainages and throat swabs. Most of the G- bacteria were sensitive to aminoglycosides,β lactam and lactamase compounds and carbapenems while G+ bacteria were sensitive only to glycopeptides. All the bacteria were resistant to quinolones, β lactams of third and forth generation. Conclusions After liver transplantation, the morbidity and mortality of the lung infections are high.The infections develope at earlier stage, manifest nontypical clinical features.Many factors are revealed to be relevant to the lung infections,meanwhile, various drug-resistant pathogen strains are isolated.

Citation： LIU Shuren,LUO Xiangrong,LOU Liming,YU Zhouyao,LI Zhuoliang.. The epidemiological characteristics of the lung infection after liver transplantation. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(1): 35-39. doi: Copy

1.	Mack CL，Millis JM，Whitington PF，et al.Pulmonary complications following liver transplantation in pediatric patients.Pediatr Transplant，2000，4：39-44.
2.	李宁，陈惠德，郎韧，等.肝移植术后肺部感染的预防.中华医院感染学杂志，2001，11：324-426.
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5.	Singh N，Gayowski T，Rihs JD，et al.Evolving trends in multiple-antibiotic-resistant bacteria in liver transplant recipients：a longitudinal study of antimicrobial susceptibility patterns.Liver Transpl，2001，7：22-26.
6.	王槐志，董家鸿，卢倩，等.25例肝移植术后肺部感染临床分析.中华医院感染杂志，2004，14：624-626.
7.	张杏怡，蔡春，王妍，等.肝移植术后肺部感染60例临床分析.中国抗感染化疗杂志，2004，4：328-331.
8.	乔志明，钱海鑫，周晓俊，等.原位肝移植术后细菌感染的分析.苏州大学学报（医学版），2006，26：491-493.
9.	郭海英，张杏怡，蔡春，等.肝移植术后肺部感染60例临床分析.中国抗感染化疗杂志，2004，4：328-331.
10.	王秀香，孙德俊，郭宏，等.医院内肺部感染的致病菌及耐药性分析.中国呼吸与危重监护杂志，2003，2：308，299.
11.	谢建国，严律南，李波，等.原位肝移植术后肺部感染与易感因素分析.中华器官移植杂志，2005，26：584-586.
12.	卢倩，闫军，王曙光，等.肝脏移植术后肺部感染病原体调查及危险因素分析.消化外科，2004，3：153-156.
13.	孟祥红，董梅，匡铁吉，等.肝移植术后感染细菌耐药性分析.中国误诊学杂志，2006，6：2049-2051.
14.	黄伟，教鸣，王晶，等.重症监护病房中产超广谱β-内酰胺酶革兰阴性细菌致院内感染的临床调查.中国呼吸与危重监护杂志，2003，2：291-293.

1. Mack CL，Millis JM，Whitington PF，et al.Pulmonary complications following liver transplantation in pediatric patients.Pediatr Transplant，2000，4：39-44.
2. 李宁，陈惠德，郎韧，等.肝移植术后肺部感染的预防.中华医院感染学杂志，2001，11：324-426.
3. 中华人民共和国卫生部.医院感染诊断标准(试行).中华医学杂志，2001，81：314-320.
4. 中华医学会呼吸病学分会.医院内获得性肺炎诊断和治疗指南(草案).中华结核和呼吸杂志，1999，22：201-203.
5. Singh N，Gayowski T，Rihs JD，et al.Evolving trends in multiple-antibiotic-resistant bacteria in liver transplant recipients：a longitudinal study of antimicrobial susceptibility patterns.Liver Transpl，2001，7：22-26.
6. 王槐志，董家鸿，卢倩，等.25例肝移植术后肺部感染临床分析.中华医院感染杂志，2004，14：624-626.
7. 张杏怡，蔡春，王妍，等.肝移植术后肺部感染60例临床分析.中国抗感染化疗杂志，2004，4：328-331.
8. 乔志明，钱海鑫，周晓俊，等.原位肝移植术后细菌感染的分析.苏州大学学报（医学版），2006，26：491-493.
9. 郭海英，张杏怡，蔡春，等.肝移植术后肺部感染60例临床分析.中国抗感染化疗杂志，2004，4：328-331.
10. 王秀香，孙德俊，郭宏，等.医院内肺部感染的致病菌及耐药性分析.中国呼吸与危重监护杂志，2003，2：308，299.
11. 谢建国，严律南，李波，等.原位肝移植术后肺部感染与易感因素分析.中华器官移植杂志，2005，26：584-586.
12. 卢倩，闫军，王曙光，等.肝脏移植术后肺部感染病原体调查及危险因素分析.消化外科，2004，3：153-156.
13. 孟祥红，董梅，匡铁吉，等.肝移植术后感染细菌耐药性分析.中国误诊学杂志，2006，6：2049-2051.
14. 黄伟，教鸣，王晶，等.重症监护病房中产超广谱β-内酰胺酶革兰阴性细菌致院内感染的临床调查.中国呼吸与危重监护杂志，2003，2：291-293.

Chinese Journal of Respiratory and Critical Care Medicine

The epidemiological characteristics of the lung infection after liver transplantation

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