The Risk Factors And Therapy Strategy Of Multidrug Resistance Acinetobacter Baumannii Infection After DCD Renal Transplantation

Objectives:With the advances in surgical techniques and immunosuppressive therapy, the quality of life and the rate of survival after renal transplantation have greatly improved. However, infection remains the major causes of morbidity and death。In recent years, the number of multiple drug-resistant bacteria infection have gradually raised, as well as the mortality, especially the multiple drug resistant acinetobacter baumannii infection.The aim is to investigate risk factors, clinical characteristics and therapy strategy of multiple drug-resistant Acinetobacter baumannii infection after renal transplantation.Methods:This retrospective study included212patients who underwent DCD renal transplantation at The First Affiliated Hospital, Medical College of Zhejiang University from March2013to September2014.The univariate and multivariate perioperative factors of Multidrug resistance Acinetobacter baumannii infection were analyzed, the clinical data and treatment of infection were depicted in detail. Results:The cases of contamination of preservation fluid, prolonged ICU stay of donor (d), the history of cardiopulmonary resuscitation,the causes of donor death are major independent risk variables of Multidrug resistance Acinetobacter baumannii infection.According to Multivariate analysis,the cases of contamination of preservation fluid, prolonged ICU stay of donor are included.24cases of preservation fluid are detected with Acinetobacter baumannii, including22cases of multiple drug resistant acinetobacter baumannii.Among24recipients,4patients had not antibiotic prophylaxis,2cases (50%) got postoperative infection;20patients had antibiotic prophylaxis,3cases (15%) got postoperative infection.Among the six infection patients,2cases were complicated with renal artery rupture,which need emergency surgical treatment.the combination of Tigecycline with high-dose Sulbactam were chosen to treat four of them, two patients were treated with monotherapy of Tigecycline. All patients have cured successfully.Conclusions:The cases of contamination of preservation fluid and prolonged ICU stay of donor are related with Multidrug resistance acinetobacter baumannii infection, We should pay more attention to the pathogen of preservation fluid.Multiple drug resistant acinetobacter baumannii infection can cause serious vascular complications, we should take some effective preemptive measures to prevent serious complications.The combination of Tigecycline with high-dose Sulbactam could be useful in the treatment of infections caused by multiple drug-resistant Acinetobacter baumannii.