Abstract:

Objective To determine whether microbial contamination of preservation solution （PS） is associated with donor derived infection （DDI）. Methods The clinical data of 624 renal transplant recipients admitted at the Organ Transplantation Center of the First Affiliated Hospital of Naval Medical University from March 2016 to September 2022 were retrospectively analyzed. Recipients were divided into positive group and negative groupaccording to the culture results of PS. The distribution of pathogenic bacteria in organ PS was analyzed and the infection events after transplantation between two groups were compared. Results Among 624 organ PS，349 cases（55.93 %）were PS culture positive， single pathogen was found in 230（65.90%）cases，and 119（34.10%） cases were found to have two kinds of pathogens. A total of 497 strains of pathogens were isolated， and the top three were coagulase negativestaphylococcus （n ＝ 83，16.70%）， Enterobacter species （n ＝ 61，12.27%） and Klebsiela pneumoniae（n ＝ 53，10.66%）. Infection rate after transplant in positive group was higher than that in negative group 〔26.36%（92/349）vs. 17.82% （49/275）〕. Statistical significance was noted between two groups（P ＜ 0.05）. A total number of 45 recipients were infected with probable donor-derived infections（p-DDIs），and 25（55.56%） recipients of which were infected with multidrug-resistant gram-negative bacteria （MDR GNB）. MDR GNB may cause severe infection-related events （P ＜ 0.05）. Conclusion Contamination of the PS is common in transplantation，it is the risk factor for postoperative infection of recipients. Organ PS should be cultured routinely. If MDR GNB are positive in PS culture， it is recommended to takespecific and effective antibacterial treatment. 

Key words:

Organ transplant ； , Organ donation after citizen’s death ； , Preservation solution ； , Donor-derived infections

摘要：

目的 探讨保存液（preservation solution，PS）的微生物污染是否与供者来源性感染（donor derived infection，DDI）相关。方法 回顾性分析海军军医大学第一附属医院器官移植中心于 2016 年 3 月至 2022 年 9 月收治的 624 例肾移植受者的临床资料，分析器官 PS 微生物学培养结果，根据培养结果分为阳性和阴性两组。分析器官 PS 中病原菌的分布情况，比较两组受者术后感染情况。结果 624 例器官 PS 中有 349 例 培养结果阳性，阳性率为 55.93%，其中 230 例（65.90%）分离出的病原菌为单一菌种，119 例（34.10%）分离出≥ 2 种的病原菌。共分离菌株 497 株，居前 3 位的是凝固酶阴性葡萄球菌（83 株，16.70%）、肠球菌属（61 株，12.27%）和肺炎克雷伯菌（53 株，10.66%）。阳性组患者移植后感染率（26.36%，92/349）高于阴性组（17.82%，49/275），差异有统计学意义（P ＜ 0.05）。45 例受者出现可能供者来源性感染（probable donorderived infections，p-DDIs），其中 25 例（55.56%）与泛耐药革兰氏阴性菌（multidrug-resistant gram-negativebacteria，MDR GNB）有关，且相较于其他病原菌更可能引发移植后严重感染事件（P ＜ 0.05）。结论 器官 PS 易受感染，PS 污染是受者术后感染危险因素之一，建议对器官 PS 常规进行培养。若 PS 培养结果存在MDR GNB，建议采取精准有效的抗感染治疗。

关键词:

器官移植 , 公民逝世后器官捐献 , 保存液 , 供者来源性感染