Objective To investigate the susceptibility profile of clinical isolates collected from renal transplant ward in a teaching hospital in 2013-2017. Methods Antimicrobial susceptibility testing was using Kirby-Bauer method or automated systems. Results were analyzed according to CLSI 2017 breakpoints. ResultsA total number of 7 530 clinical specimens were collected from renal transplant unit in 2013—2017，including urine 2 521（33.5%），drainage of liquid 2 299（30.5%），blood specimens 1 187（15.8%），other 1 523（20.2%）. A total number of 1 536 isolates，648 isolates not repeated，590 strains（91.0%）was bacteria，58 strains（9.0%）was fungi， the top five isolates were Enterococcus faecium（19.8%），Escherichia coli（15.6%），Klebsiella pneumoniae（8.3%）， Pseudomonas aeruginosa（4.6%）and Acinetobacter baumannii（4.5%），respectively. Separation of fungi is given priority to with Candida albicans and Candida glabrata（46.4%）. Prevalence of ESBLs-producing strains was 89.1% in Escherichia coli，71.7% in Klebsiella pneumoniae，8.2% of these strains were resistant to carbapenems. The resistant rate of 69.0% to Pseudomonas aeruginosa and 23.3% to Acinetobacter baumannii，respectively. The overall prevalence of methicillin-resistant strains was 78.6% in Staphylococcus aureus and 93.3% in Staphylococcus epidermidis， respectively. No staphylococcal strains were found resistant to vancomycin. The resistance rates of Enterococcus faecalis strains to most drugs tested（except tetracyclines）were much lower than those of Enterococcus faecium. No strains of both species were resistant to vancomycin Conclusion Bacterial resistance to commonly used antibiotics is still on the rise，especially the Carbapenem-resistant Enterobacteriaceae（CRE）isolates has a tendency to increase year by year. It is necessary to strengthen hospital infection control and management of clinical use of antimicrobial agents，and maintain good practice in surveillance of bacterial resistance.

Objective To summarize the differences in clinical features and treatment between the liver transplant recipients and kidney transplant recipients. Methods The data of Clinical manifestations, laboratory examination and imaging and treatment of 43 patients who were infected TB after liver or kidney transplantation from April 2002 to October 2017 were retrospectively analyzed. Results The rates of tuberculosis infection after liver and kidney transplantation were 1.73% and 1.50%, respectively. There was no statistical difference between the two groups（P ＞ 0.05）. The time of tuberculosis infection in liver and kidney transplantation group was（18.25± 28.12）months and（26.74±37.96）respectively. There was a statistically significant difference between the groups （P ＜ 0.05）. Fever was the primary or only manifestation in both groups, and the onset rates of fever were 70.37% and 93.75%, respectively, there was no statistical difference between the two groups（P ＞ 0.05）. The rates of pulmonary tuberculosis was 51.85% and 50.00% respectively in the two groups，and there was no statistical difference between the two groups（P ＞ 0.05）. The positive rates of T-SPOT.TB in the two groups were 85.19% and 81.25%, respectively. There was no statistical difference between the two groups（P ＞ 0.05）. The effective rates of two groups were 81.48% and 81.25%, respectively, and the mortality rates were 14.81% and 12.50%，respectively. There was no significant difference between the two groups in terms of treatment efficiency and mortality（all P ＞0.05）. Conclusion The incidence of tuberculosis infection in liver and kidney transplant recipients are both high. The incidence of tuberculosis infection after liver transplantation is earlier than that in renal transplant recipients. The immune status of tuberculosis patients after liver and kidney transplantation is different. Most patients in both groups achieved good results after standardized individualized treatment, but they were easily died of various serious complications such as organ failure.

Objective To investigate the incidence，epidemiological characteristics，the clinical features and the treatment of mid-long-term cytomegalovirus（CMV）infection after liver transplantation. Methods The patients with mid-long-term cytomegalovirus infection after liver transplantation in the Armed Police General Hospital between January 2005 and April 2012 were analyzed retrospectively. CMV immunoglobulin M（CMV-IgM） and immunoglobulin G（CMV-IgG）were detected by serological method. CMV antigen（CMV-pp65）was detected by immulogical stain，and CMV-DNA was detected by fluorescent quantitative PCR. Results A total number of 736 cases of liver transplantation were performed，and 163 cases of postoperative infection occurred. The overall incidence was 22.1%. Among them，there were 14 cases of CMV infection the incidence of which was 1.9%. CMV infection occurred between 1-86 month after the operation，and the average time of CMV infection was 7 months. Conclusion Mid-long-term CMV infection after liver transplantation is a problem that cannot be ignored，and the abilities of recognition and diagnosis should be improved.

Objective To explore the clinical characteristics of cytomegalovirus pneumonia after renal transplantation. To analyze the risk factors of cytomegalovirus pneumonia after renal transplantation. Methods A total of 1 598 cases renal transplant patients in General Hospital of Chinese People 's Armed Police Forces from June 2005 to August2017 were analyzed retrospectively. The clinical data of cytomegalovirus pneumonia of 59 cases renal transplant patients were collected. Clinical characteristics and risk factors of cytomegalovirus pneumonia after renal transplantation were analyzed. Results The incidence of cytomegalovirus pneumonia after renal transplantation was 3.7% and the mortality rate was 6.8%. CD4 lymphocyte count and steroid excess were risk factors of cytomegalovirus pneumonia after renal transplantation. Conclusion The incidence of cytomegalovirus pneumonia after renal transplantation was higher. The use of immunosuppressive agents maybe the main risk factors of cytomegalovirus pneumonia after renal transplantation.

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.

Objective To investigate prognostic factors for patients with hepatic encephalopathy（HE）and hepatocellular carcinoma（HCC）undergoing Liver transplantation. Methods Retrospectively we analyzed the clinical data and survival outcomes of 292 patients with hepatic cirrhosis and primary hepatocellular carcinoma who underwent first liver transplantation in Tianjin First Center Hospital. Kaplan-Meier survival curves were established to compare the 5-year survival of patients with or without HE. Univariate and multivariate Cox proportional hazard models were performed to identify independent risk factors for poor outcomes. Results The overall long-term survival rate of patients in HE group was not lower than that in none-HE group. Univariate analysis showed that thehigh risk index of tumor prognosis was AFP ＞ 1 000 μg/L，portal vein embolization，TNM staging，stage Ⅲ，Ⅳ stage，moderate differentiation and low differentiation. Independent risk factors for postoperative cumulative survival included AFP，tumor size，differentiation，portal vein thrombosis，and TNM staging. Conclusion HE is not a major risk factor effecting post-transplant mortality of patients with HCC. Presence of HE improve detection rate of early HCC. Positive control of HE during pre-transplant period is beneficial for prognosis.

Objective To observe the effect of preventing the recurrence of hepatitis B with the combination entecavir and hepatitis B immune globulin（HBIG）in the hepatitis B surface antigen（HBsAg）positive renal transplant receipts，which received the HBsAg positive allograft. Methods The clinical data of 30 cases renal transplant were retrospectively analyzed from January 2015 to August 2017. To prevent outbreak of hepatitis B in the early time，the stategry was that the recipients with HBsAg positive received the allograft with hepatitis B positive. Prior to the transplantation，the 100 ml HTK preservation solution with HBIG 400 U was perfused into the kidney through the renal artery. In addition，entecavir was used for prophylaxis postoperatively. All of them were followed up for 3 to 36 months，the graft function，liver function，HBV DNA，and recipient and graft survival rates were evaluated. Results Up to October 2017，with 6 ～ 36 months follow-up，the one year survival of allograft was 100%. The one year survival of recipients was 100%. Post-transplantation 3 weeks，the liver function was ALT（67±17）U/L，AST（53±12）U/L. Serum creatine was（112±67.3）μmol/L and HBV DNA was 1×102 ～ 5×108 copies/ml. HBV DNA increased significantly for two cases. One patients came to cirrhosis compensatory phase.There was no case with acute liver failure and liver tumor. Conclusion The HBIG plus entecavir in HBsAg positive recipients which received allograft from HBsAg positive donor can effectively prevent outbreak of hepatitis B in short term. The conclusion should be made by large clinical trials in the future.