To explore the infection status and risk factors after kidney transplantation.

The clinical data of 94 recipients who received kidney transplantation in Beijing Friendship Hospital, Capital Medical University from January 1 to December 31, 2018 were retrospectively analyzed. All the donor kidneys were preserved with Lifeport for low-temperature mechanical perfusion, and cefoperazone sulbactam sodium was added to the perfusion solution to prevent donor-derived infection. According to the results of body fluid culture within 3 months after transplantation, 94 recipients were divided into infection group and control group. Chi-square test was used to compare the sex of recipients, the ratio of positive perfusate culture and incidence of delayed graft function (DGF) in infected and control groups. Wilcoxon signed rank sum test was used to compare the age, preoperative serum creatinine and hospitalization time of the two groups. The variables with statistical difference in univariate analysis were included in Logistic regression for multivariate analysis. P<0.05 was considered statistically significant.

Pathological bacteria were cultured in blood, urine, sputum and drainage fluid specimens of 41 recipients within 3 months after transplantation, the infection rate was 43.6% (41/94), and infections mostly occurred during 1 week to 1 month after transplantation, accounting for 34.0% (32/94). A total of 58 infections occurred in 41 recipients. The pathogens were mostly from the urinary system, accounting for 51.7% (30/58), followed by surgical site infections and blood infections, accounting for 32.8% (19/58) and 13.8% (8/58), the lowest proportion of respiratory tract infections, accounting for 1.7% (1/58). 27 recipients were infected with a single pathogen, and 14 were infected with 2 or more pathogens. A total of 66 pathogenic bacteria were isolated from 41 recipients, of which bacteria accounted for 89.4% (59/66) and fungi accounted for 10.6% (7/66). As of July 10, 2019, 94 recipients have survived, all infections had improved after treatment, and no serious infectious diseases or graft loss due to infection had occurred. Univariate analysis showed that there was no statistically significant difference between the infected group and the control group in age, gender, pre-transplant serum creatinine and hospitalization time (z=-0.206, χ²=0.628, z=-0.599, z=-0.031, P all >0.05); the ratio of positive perfusate culture and the incidence of DGF between the two groups of recipients were statistically significant (χ²=0.031 and 0.274, P all <0.05). Logistic regression multivariate analysis showed that positive perfusate culture was an independent risk factor for infection after kidney transplantation (P<0.05).

Kidney transplant recipients have a higher incidence of postoperative infections, the main site of infection is the urinary system, and positive perfusate culture is an independent risk factors for infections after kidney transplantation.