关键词:

Abstract:

Objective To investigate the clinical features of donor-derived drug-resistant Klebsiella pneumoniae infection and to summarize the experience of clinical treatment after liver transplantation. Methods Retrospective analysis was performed based on clinical data and the diagnosis and treatment of three live transplantrecipients with donor-derived carbapene-resistant Klebsiella pneumoniae（CRKP）infection in Department of Hepatobiliary Surgery，the Third Hospital of Hebei Medical University. Results Three recipients with donor-derived CRKP infection were confirmed by bacterial culture and were treated with anti-infection therapy（ceftazidine-avibactam combined with carbapenems），and one of them developed abdominal infection after transplantation withoutanti-infection therapy. After removal of abdominal abscess，ceftazidine-avibactam standard dose（3.75 g / d）was used to this recipient. The infection was not well controlled，and the patient eventually died. Standard measurement was used in another case，and bleeding occurred at the anastomotic site of hepatic artery 3 weeks after the operation. After two operations，high dose treatment（7.5 g /d）was used，the recipient and the transplanted liver survived. High doses treatment（7.5 g / d）was given to the third patient, the infection was control 4 weeks after treatment，sputum culture and blood culture were negative，the recipient and graft survived. Conclusion The infection of donor CRKP significantly increases the mortality of liver transplantation patients. The early application of ceftadiene-avibatan combined with carbapenems combined with anti-infection treatment has a good effect，and increasing the dose of ceftadiene-avibatan can improve the curative effect，without any obvious adverse reactions.

Key words: