Objective To discuss clinical diagnosis and treatment strategy for early urinary tract infection （UTI）after renal transplantation. Methods A retrospective analysis for 98 early UTI patients was conducted who recept renal transplantation between April 2012 and August 2017 in the First Hospital of Jilin University. The laboratory results of pathogens for early UTI after renal transplantation were studied. Results In the 98 patients，130 UTI patients were found，including 76 patients with UTI for one time，16 patients with UTI for 2 times and 7 patients with UTI for more than 3 times. Major symptoms were fever and urinary tract irritation. The timeof hospitalization was（10.3±4.4）days. Among the 130 results of urine cultures ，the gram-negative bacilli was found in 51.5% cultures，mainly Escherichia coli and Klebsiella, while gram-positive bacilli accounted for 8.5%，mainly Enterococcus and Staphylococcus. Virus accounted for 4.6%，including BK，JC，HCMV virus，and the remaining (20%) was negative. In 119 blood cultures, gram-negative bacilli , gram-positive bacilli and negative accounted for 15.1%, 1.5% and 83.4%, respectively. The serum creatinine was（132.7±63.0）μmol/L before admission，while the serum creatinine was（110.9±62.3）μmol/L after treatment. All patients were clinically cured from UTI. Six cases of renal allograft rejectionoccurred. Five cases of renal allograft rejection recovered and one case appeared renal failure after anti rejection treatment. The incidence of UTI in male and female were 14.4% and 24.6%, respectively. The incidence of UTI in living related kidney transplantation and other renal transplantation were 7.4% and 14.8%, respectively. Conclusion UTI is related to gender，age，type of transplantation，intraoperative operation， immunosuppressant，diabetes and urinary foreign bodies（such as ureteral stent，catheter and fistulae）. The incidence of UTI in male is lower than that in female. The incidence of UTI in relative renal transplantation is lower than that in other renal transplantation. The diagnosis of UTI is based on clinical symptoms and urine test. Besides etiological treatment，other symptomatic support treatment should be conducted, including anti infection treatment according to the results of blood/urine culture，immunosuppressant adjustment according to the blood concentration， giving regular replacement of drainage，alkalization of urine，increasing fluid intake，enhancing immunity and keeping the perineum clean. Early prevention of UTI contributes to improving the quality of life and the survival time of transplanted kidney.

目的 探讨肾移植术后早期尿路感染（UTI）的临床诊治策略。方法 回顾性分析吉林大学 第一医院 2012 年 4 月— 2017 年 8 月收治的 98 例肾移植术后早期 UTI 患者的临床资料，分析肾移植术后早 期 UTI 的病原学结果及病因。结果 98 例患者中，UTI 频次累计 130 次，其中 76 例出现 1 次，16 例出现 2 次，7 例出现 3 次以上。患者多以发热、尿路刺激征为主要症状，住院时间为（10.3±4.4）天。130 份 尿培养病原学结果中，革兰阴性（G- ）菌占 51.5%，以大肠埃希菌、克雷伯杆菌为主 ；革兰阳性（G+ ）菌 占 8.5%，以肠球菌、葡萄球菌为主，病毒 4.6%，为 BK 病毒、JC 病毒、人巨细胞病毒（HCMV）病毒，混 合感染 15.4%，20.0% 病原学结果阴性。留取血培养标本 119 份，15.1% 为 G- 菌，1.5% 为 G+ 菌，余病原 学阴性。入院前血肌酐为（132.7±63.0）μmol/l，出院时血肌酐为（110.9±62.3）μmol/l。患者均临床治愈， 其中 6 例患者治疗期间出现移植肾排斥反应，抗排斥治疗后 5 例肾功能恢复至正常水平，1 例出现移植肾 功能衰竭。男性 UTI 发病率为 14.4%，女性 UTI 发病率为 24.6%。亲属肾移植 UTI 发病率为 7.4%，其他类 型肾移植 UTI 发病率为 14.8%。结论 UTI 病因与性别、年龄、移植类型、术中操作、免疫抑制剂、糖尿 病、尿路异物（移植肾输尿管支架管、导尿管、造瘘管）等因素有关。男性 UTI 发病率较女性 UTI 发病率低。 亲属肾移植 UTI 发病率较其他类型肾移植 UTI 发病率低。UTI 以临床症状、尿液检验为诊断依据，治疗上 除对因治疗外，依据血尿培养结果抗感染治疗，根据血药浓度调整免疫抑制剂剂量，并给予定期更换造瘘管、 碱化尿液、增加入液量、增强免疫力、保持会阴清洁等对症支持治疗。早期预防 UTI，有利于提高患者生 活质量及移植肾存活时间。